WO2022054439A1 - Medical image processing system, medical image processing method, information processing device, and program - Google Patents

Medical image processing system, medical image processing method, information processing device, and program Download PDF

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Publication number
WO2022054439A1
WO2022054439A1 PCT/JP2021/027899 JP2021027899W WO2022054439A1 WO 2022054439 A1 WO2022054439 A1 WO 2022054439A1 JP 2021027899 W JP2021027899 W JP 2021027899W WO 2022054439 A1 WO2022054439 A1 WO 2022054439A1
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image processing
image
processing
priority
medical
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PCT/JP2021/027899
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French (fr)
Japanese (ja)
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大暉 上原
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富士フイルム株式会社
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Priority to DE112021004715.9T priority Critical patent/DE112021004715T5/en
Priority to JP2022547432A priority patent/JPWO2022054439A1/ja
Publication of WO2022054439A1 publication Critical patent/WO2022054439A1/en
Priority to US18/168,571 priority patent/US20230197252A1/en

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Definitions

  • the present invention relates to a medical image processing system, a medical image processing method, an information processing apparatus, and a program, and in particular, an image processing server receives an image to be processed and a processing request, executes processing according to the processing request, and obtains a processing result.
  • the present invention relates to a medical image processing technique suitable for providing a medical image processing service returned to a requester.
  • CAD computer-aided diagnosis
  • Patent Document 1 describes a mechanism for optimizing the allocation of computational resources such as a CPU (Central Processing Unit) and memory for various analysis processes within the allocated computational resources in an image processing program that performs various medical image analysis. Has been proposed.
  • CPU Central Processing Unit
  • Patent Document 2 describes a method of optimizing a process of storing and / or communicating a medical image taken by using an image diagnostic apparatus in a medical image storage communication system (Picture Archiving and Communication System: PACS). Has been proposed.
  • PACS Picture Archiving and Communication System
  • a medical image processing service that receives medical images and processing requests stored in each medical institution from a plurality of medical institutions and returns the processing results to the request source is provided.
  • various medical image processing functions such as lung CAD are provided from an image processing API server.
  • the lung CAD includes, for example, an AI processing module using a trained AI model that uses a CT image of a lung as input data and outputs a detection result of a lung disease region and / or a recognition result of a disease name (disease name).
  • the image In order to respond to such a request, as soon as an image is taken by modality, the image is automatically acquired from a DICOM (Digital Imaging and Communication in Medicine) server, etc., and possible processing for the image is automatically performed. You need the ability to do it. At this time, if the automatically acquired image is such that a processing request is made for all the images that meet the automatic execution conditions of image processing, the following problems occur.
  • DICOM Digital Imaging and Communication in Medicine
  • a processing request is thrown from a terminal on the medical institution side to a destination (processing request destination) to which a processing request is thrown, such as an image processing API deployed on-premises or on the cloud.
  • a destination processing request destination
  • the computational resources (resources) of are tight, if all the processing requests that meet the automatic execution conditions are thrown, the resource of the processing request destination will be used for the calculation to obtain the low priority processing result. It may be oppressed and high priority processing may not be executed easily.
  • the low-priority processing result here means, for example, an image processing result that is rarely used in an actual diagnostic workflow.
  • the operation on the server side becomes unstable or the minimum required processing result on the client terminal side. There may be a long waiting time for the acquisition.
  • the present disclosure has been made in view of such circumstances, and is a medical image processing system and a medical image processing method capable of solving at least one of the above-mentioned plurality of problems and ensuring the stability and usability of the system.
  • Information processing equipment and programs are provided.
  • the present disclosure is a processing request by dynamically determining the priority of the requested processing when the processing request is thrown on the client terminal side that automatically requests the processing for a new image taken by the modality.
  • the medical image processing system is a medical image processing system including an image processing server that performs image processing of medical images and an information processing device connected to the image processing server via a network.
  • the image processing server includes one or more first processors, in which the first processor executes a plurality of processing modules for performing a plurality of image processes, and the information processing apparatus determines the image to be processed and the processing request. Is received, image processing corresponding to the processing request is performed, and the processing result is returned to the request source.
  • the information processing apparatus includes one or more second processors, and the second processor is connected to the information processing apparatus.
  • Image processing can be performed for the acquired new image, which image processing can be executed among multiple image processes, the load status of the image processing server can be grasped, and the determined image processing can be performed. Based on the priority of each one or more image processing and the grasped load status of the image processing server, the processing request of one or more image processing that can be executed according to the priority standard to the image processing server. To send.
  • the medical image processing system of this embodiment when the information processing apparatus on the side issuing the processing request sends a processing request for image processing to the acquired image, the load status of the image processing server is grasped and the target image is displayed.
  • the processing request to be sent to the image processing server can be determined. Control the number (number of processing requests sent).
  • processing requests for high-priority processing are prioritized according to the load status, and when the resources of the image processing server are tight, processing requests for low-priority processing are suppressed.
  • the priority of each image processing is calculated based on the operation log when the user refers to the processing result using the image viewer, the processing result that is highly necessary for the user or the processing result with high priority is calculated. Can be determined appropriately. According to this aspect, even in a situation where the resources of the image processing server are tight, the processing result with high priority can be acquired relatively early, and the stability and / or responsiveness of the entire system can be obtained. Can be secured.
  • the image processing server may be configured to be installed on a network accessible from each information processing device of a plurality of medical institutions.
  • a plurality of information processing devices connected to an image processing server via a network are included, and each of the plurality of information processing devices is within a medical institution of a different medical institution.
  • the configuration may include terminals connected to the network.
  • an image storage server for storing images taken by one or more modality may be installed on a network in a medical institution.
  • the information processing apparatus acquires information on the reference count and the reference order of the image processing processing result from the operation log, and uses the reference count and reference order information to be used for each. It may be configured to calculate the priority of image processing.
  • the information processing device may be configured to also serve as an image viewer.
  • a plurality of image viewers are connected to the network in the medical institution, and the information processing apparatus collects and collects operation logs of the plurality of image viewers.
  • the priority may be calculated by statistically processing the information recorded in the operation log of.
  • the information processing apparatus performs an organ extraction process for extracting the organs shown in the acquired new image, and based on the information of the extracted organs, a plurality of organs are extracted. It may be configured to discriminate the image processing related to the organ from the image processing as the feasible image processing.
  • the information processing apparatus determines an image processing that can be performed from a plurality of image processings based on the tag information attached to the acquired new image. It may be a configuration.
  • the image processing server includes an endpoint that receives an inquiry about the load status from the information processing device and responds to the current load status, and the information processing device is an end. It may be configured to use points and acquire information indicating the load status of the image processing server from the endpoint.
  • the information processing apparatus records the response time from the transmission of the processing request to the image processing server until the processing result is obtained for each processing request, and responds. By calculating the rate of increase in time, the load status of the image processing server may be grasped.
  • the information processing apparatus compares the grasped numerical value indicating the load status of the image processing server with the threshold value, and makes an image of the processing request for the processing of the priority according to the threshold value. It may be configured to send to the processing server.
  • the priority may be divided into 50 or more levels from the lowest priority level to the highest priority level.
  • the plurality of image processing is at least one of computer detection support (Computer Aided Detection: CADe) processing and computer diagnosis support (Computer Aided Diagnosis: CADx) processing. It may be a configuration including processing.
  • the plurality of processing modules may be configured to include a CADe module that processes CADe and a CADx module that processes CADx.
  • the CADe processing priority may be set to a higher priority than the CADx processing priority.
  • the plurality of processing modules may be configured to include a processing module that performs a report creation support process including a process of generating a candidate for a finding sentence.
  • the priority of the report creation support process is set to be lower than the priority of the CADe process and the priority of the CADx process. It may be a configuration.
  • the plurality of image processing includes a fracture detection process for detecting the position of a fracture, a bone labeling process for labeling a bone number, and a lung for detecting the position of a lung nodule. It may be configured to include at least one of a nodule detection process, a property discrimination process for differentiating the properties of lung nodules, and a lung area labeling process for lung area labeling.
  • an image processing server that processes an image to be processed and a processing request from an information processing apparatus connected to an image processing server capable of performing a plurality of image processing via a network.
  • This is a medical image processing method in which the image processing server performs image processing corresponding to the processing request and returns the processing result to the request source. Obtained by collecting the operation log of the image viewer used when viewing the processing result of image processing, calculating the priority of each of multiple image processing based on the collected operation log, and calculating. It records the priority information, updates and manages the priority information of each of multiple image processes, and acquires new images taken by one or more modalities connected to the network in the medical institution.
  • the image processing server is subject to the priority criteria of one or more image processing that can be performed. Including making a processing request.
  • the information processing apparatus is an information processing apparatus connected to an image processing server capable of performing a plurality of image processing via a network, and includes one or more processors. , Collect the operation log of the image viewer used when the user browses the processing result of image processing on the network in the medical institution to which the information processing device is connected, and based on the collected operation log, multiple image processing Calculate each priority of, record the priority information obtained by the calculation, update and manage each priority information of multiple image processing, and one or more connected to the network in the medical institution. Acquires a new image taken by the modality of, determines what image processing can be executed among multiple image processes for the acquired new image, and grasps the load status of the image processing server. , One that can be executed according to the priority criteria for the image processing server based on the priority of each of the determined one or more image processing that can be executed and the load status of the grasped image processing server. The processing request for the above image processing is transmitted.
  • the program according to another aspect of the present disclosure is a program for making a computer function as an information processing apparatus connected to an image processing server capable of performing a plurality of image processing via a network, and the computer is informed of information.
  • Multiple image processing based on the function to collect the operation log of the image viewer used when the user browses the processing result of the image processing on the network in the medical institution to which the processing device is connected, and the collected operation log.
  • a function to acquire a new image taken by one or more modalities a function to determine which image processing among a plurality of image processes can be executed for the acquired new image, and an image.
  • Priority is given to the image processing server based on the function of grasping the load status of the processing server, the priority of each of the determined and executable image processing, and the grasped load status of the image processing server. It is a program for realizing a function of transmitting a processing request for one or more image processing that can be executed according to a standard of degree.
  • the number of processing requests sent to the image processing server is effective based on the load status of the image processing server and the priority of each image processing. Can be narrowed down to. According to the present invention, it is possible to ensure the stability of the operation of the image processing server that provides the processing result of the image processing according to the processing request. In addition, the information processing apparatus according to the present invention can quickly acquire processing results that are highly necessary for the user, and usability is ensured.
  • FIG. 1 is a block diagram schematically showing the configuration and operation of the medical image processing system according to the embodiment of the present invention.
  • FIG. 2 is a flowchart showing the operation flow of the medical image processing system shown in FIG.
  • FIG. 3 is a flowchart showing an example of the operation related to the priority calculation.
  • FIG. 4 is a diagram schematically showing a system configuration example of a medical image processing system.
  • FIG. 5 is a block diagram showing a configuration example of an image processing API server.
  • FIG. 6 is a block diagram showing a configuration example of an image processing management terminal on a network in a medical institution.
  • FIG. 7 is a block diagram showing a configuration example of a viewer terminal.
  • FIG. 8 is a block diagram showing an example of a computer hardware configuration.
  • FIG. 1 is a block diagram schematically showing the configuration and operation of the medical image processing system 10 according to the embodiment of the present invention.
  • the medical image processing system 10 comprises a terminal 20 installed on a network in each medical institution of a plurality of medical institutions and an image processing API server 30 installed on a network accessible from the terminal 20 of each medical institution. include.
  • the terminal 20 refers to a computational resource existing in a network that can safely access data in a medical institution, and the terminal 20 does not have to physically exist in the medical institution.
  • the terminal 20 of each medical institution may be a physical machine or a virtual machine, and the specific form is not limited.
  • a typical example of a medical institution is a "hospital”.
  • the indications of "hospital 1", “hospital 2" ... "hospital N" shown in FIG. 1 indicate that N medical institutions exist.
  • At least one terminal 20 for one medical institution is provided on the medical institution network.
  • the terminal 20 is an example of the "information processing device" in the present disclosure.
  • the image processing API server 30 is a central image processing server that receives an image processing request from each terminal 20 of N medical institutions, executes the requested image processing, and returns the processing result to the request source.
  • Modality 40 is a device for taking an inspection image.
  • the modality 40 includes a device that generates an inspection image representing the inspection target portion of the subject by photographing the inspection target portion, adds incidental information defined by the DICOM standard to the image, and outputs the inspection image.
  • Specific examples of the modality 40 include a CT device (Computed Tomography), an MRI device (magnetic resonance imaging), an angiography X-ray diagnostic device, and a PET device (Positron Emission Tomography). Examples thereof include a tomography apparatus), an ultrasonic apparatus, a CR apparatus (Computed Radiography: computer X-ray imaging apparatus) using a flat X-ray detector (FPD), a mammography apparatus, and an endoscopic apparatus.
  • the DICOM server 50 is a server that operates according to the DICOM specifications.
  • the DICOM server 50 is a computer that stores and manages various data including images taken by using the modality 40, and includes a large-capacity external storage device and a database management program.
  • the DICOM server 50 is an example of the "image storage server" in the present disclosure.
  • a viewer 202 In each medical institution, a viewer 202, an operation log collection unit 204, a priority information update management unit 206, and an image processing automatic request unit 208 are constructed on one or more terminals 20.
  • Viewer 202 includes an image interpretation viewer program that assists the diagnostic workflow of diagnostic imaging by a physician.
  • the viewer 202 causes the display device to display the inspection image, the image processing result, and the like.
  • the viewer 202 may be dedicated browsing software, a Web browser, or the like.
  • the viewer 202 is an example of the "image viewer" in the present disclosure.
  • the operation log collection unit 204 is a program that collects operation logs when the user 60 uses the viewer 202.
  • the operation log collection unit 204 automatically collects operation logs at appropriate timings without making the user 60 aware of the operation log collection work.
  • the collected operation log data is stored in the operation log database (DataBase: DB) 205.
  • the user 60 is mainly a doctor or the like, and is a person who refers to the image processing result by using the viewer 202.
  • the priority information update management unit 206 is a program that calculates the priority of various medical image processing based on the operation log collected by the operation log collection unit 204.
  • the priority information update management unit 206 may calculate the priority for each individual based on the operation log acquired for each individual of the user 60, or statistically process the operation log of the plurality of users 60 for medical treatment. You may calculate the priority of the average usage assumption in the institution.
  • the image processing automatic request unit 208 acquires an image stored in the DICOM server 50, selects an image process to be applied to the acquired image, and performs an image processing API according to the priority information determined by the priority information update management unit 206. This is a program that requests image processing from the server 30.
  • the image processing API server 30 may exist on a network that can be safely accessed from the image processing automatic request unit 208 on the respective medical institution networks of a plurality of medical institutions, and may be in any form such as a physical machine or a virtual machine. ..
  • the image processing API server 30 may be a cloud server or an on-premises server.
  • the image processing API server 30 is an example of the "image processing server" in the present disclosure.
  • FIG. 1 shows an example in which the viewer 202, the operation log collection unit 204, the priority information update management unit 206, and the image processing automatic request unit 208 are constructed on one terminal 20.
  • the program may be distributed and constructed in two or more terminals existing on the network in the medical institution.
  • the viewer 202 is built on the first terminal, and the operation log collection unit 204, the priority information update management unit 206, and the image processing automatic request unit 208 are built on a second terminal different from the first terminal. May be done.
  • the viewer 202, the operation log collection unit 204, the priority information update management unit 206, and the image processing automatic request unit 208 may be constructed on separate terminals.
  • the flow of the procedures [a] to [d] in FIG. 1 shows the flow from the inspection image being taken by the modality 40 to the processing request being made to the image processing API server 30.
  • the flow of procedures [0] to [4] in FIG. 1 shows a flow in which the user 60 calculates the priority of various image processing from the operation log using the viewer 202.
  • the flow of steps [a] to [d] and the flow of steps [0] to [4] may be performed in parallel.
  • FIG. 2 is a flowchart showing the operation flow of the medical image processing system 10.
  • the inspection image is taken by the modality 40 (step S11).
  • the inspection image taken by the modality 40 is stored in the DICOM server 50 (step S12, procedure [a] in FIG. 1).
  • the image processing automatic request unit 208 automatically acquires the image newly saved in the DICOM server 50 (step S13, procedure [b] in FIG. 1), and the image processing automatic request unit 208 obtains the image.
  • the processing content is determined as to what kind of processing should be performed (step S14, procedure [c] in FIG. 1).
  • “automatically” means that the user does not need to input an instruction by each operation from the user 60, and the image taken by the modality 40 is saved in the DICOM server 50. It means that it is automatically performed in the background in conjunction with the operation.
  • the image processing automatic request unit 208 performs organ extraction processing on the acquired image.
  • Information on which organ is shown may be extracted, and for example, if the lung is shown, lung nodule detection may be performed.
  • One or more image processes that can be executed are associated with each organ, and one or more image processes that can be executed are determined according to the extracted organ. There may be a plurality of image processes that can be executed for one image.
  • the image processing automatic request unit 208 may use the information obtained from the DICOM tag attached to the image as the processing applicability determination criterion.
  • the information obtained from the DICOM tag for example, conditions such as CT slice thickness may be used. If the CT slice thickness is thick, there may be some processing that cannot be performed. Therefore, it may be determined whether or not the treatment can be applied based on the information on the CT slice thickness, provided that the treatment can be performed when the CT slice thickness is equal to or less than a predetermined reference value.
  • the applicability of the treatment may be determined by the combination of the result of organ extraction and the condition of CT slice thickness.
  • DICOM tag information is an example of "tag information" in the present disclosure.
  • the image processing automatic request unit 208 grasps the load status of the image processing API server 30 before transmitting the processing request determined to be applicable to the acquired image to the image processing API server 30. (Step S15).
  • the method of grasping the load status responds to the load status on the image processing API server 30 side, such as an API endpoint (Endpoint) that returns the number of processes waiting in the current image processing API server 30.
  • the API endpoint to be used may be provided on the image processing API server 30 side, the API endpoint may be used by the image processing automatic request unit 208, and the load status of the image processing API server 30 may be acquired from the response content.
  • the API endpoint is an example of an "endpoint" in the present disclosure.
  • the image processing automatic request unit 208 processes the response time from sending the processing request to the image processing API server 30 until the processing result is obtained. It may be possible to grasp the load status by recording each request in the image processing automatic request unit 208 and calculating the increasing tendency of the time until the response is returned.
  • the image processing automatic request unit 208 acquires the latest priority information of each process from the priority information update management unit 206 as necessary (step S16, procedure [4] in FIG. 1).
  • the image processing automatic request unit 208 compares the numerical value indicating the load status grasped in step S15 with the threshold value, and requests the image processing API server 30 to process the priority according to the threshold value (step S17, FIG. 1). Procedure [d]).
  • the priority is divided into 100 levels from “1" indicating the lowest level to "100" indicating the highest level, and the priority is determined for each process by the priority information update management unit 206.
  • the image processing automatic request unit 208 transmits, for example, a processing request having a priority of 30 to 100 when the increase rate of the response time of the image processing API server 30 is 30% in the last 10 requests. And so on.
  • priority 1 to 100 is shown here as an example of the particle size of priority, the definition of priority is not limited to this example. In order to flexibly set priorities for multiple image processes, it is desirable to make the priority particles finer.
  • the priority is preferably divided into 50 or more levels from the lowest priority level to the highest priority level, and more preferably 100 or more levels.
  • the priority level may be defined in 256 levels or 1024 levels.
  • the image processing API server 30 that received the processing request from the image processing automatic request unit 208 executes the requested processing (step S18).
  • the image processing automatic request unit 208 acquires the processing result from the image processing API server 30 at an appropriate timing (step S20).
  • the image processing API server 30 may notify the image processing automatic request unit 208 that the processing result has been created, or the image processing automatic request unit 208 periodically performs image processing.
  • the flow may be such that the API server 30 is inquired about the existence of the processing result and the processing result is acquired when the processing result is obtained.
  • the image processing automatic request unit 208 that has acquired the processing result from the image processing API server 30 saves the processing result in a format that can be referred to by the viewer 202 (step S21).
  • the processing result information may be associated with the image and stored in the DICOM server 50.
  • the user 60 can refer to the processing result through the viewer 202 (step S22).
  • step S13 when the calculation resource of the image processing API server 30 is abundant in response to the processing request from the image processing automatic request unit 208, when the user 60 refers to the processing result in the above procedure, step S13. It is assumed that all the processing results determined to be applicable to the image acquired from the DICOM server 50 by the image processing automatic request unit 208 in step S14 can be referred to in the viewer 202. As a result of considering the load status of the image processing API server 30, when the processing requests to be transmitted from the image processing automatic request unit 208 are narrowed down, some results cannot be prepared when the user 60 refers to the processing results. Is assumed. Specific examples of such cases will be described below.
  • fracture CAD for detecting a fracture from an image
  • bone labeling for labeling a bone number. Since fracture CAD is often performed at the beginning of the diagnostic workflow to find a fracture, the results are often referred to in the viewer 202, and the fracture CAD processing results can be referenced by the user 60 at an early stage. Is desirable.
  • bone labeling is, for example, a process of automatically recognizing the number of the spine, and the labeling of the bone number obtained as a result of bone labeling is a fracture in the report when the fracture is detected by the fracture CAD. While it plays an important role in identifying the location, if no fracture is detected, there is no need to write the bone number in the report, and bone labeling does not have to be done. Further, even if a fracture is detected but there is no result of bone labeling, it is a little inconvenient for the user 60 side, but the report itself can be created by specifying the bone number by oneself. For this reason, in this example, it is possible to make a determination such as "fracture CAD> bone labeling" as the priority of image processing.
  • Such a relative magnitude relationship of priorities may be determined in the default priority setting (factory setting) or may be determined from the analysis result of the operation log of the viewer 202. For example, there is a default priority setting, and then the preference of the user 60 in each medical institution may be reflected in the priority from the analysis of the operation log.
  • each processing request it is also conceivable to initially send each processing request to the image processing API server 30 without giving any priority.
  • the user 60 such as a doctor may feel inconvenience because it takes time until the processing result can be referred to at first, but the processing waiting until the processing is completed is a high-priority processing and does not wait. If the process is canceled, the priority can be set for each process as a process with a low priority, and thereafter, the process that reflects the priority becomes possible.
  • the image processing automatic request unit 208 prioritizes the processing request of the fracture CAD over the processing of the bone labeling.
  • ⁇ Specific example 2> there are three processes of lung nodule detection, lung area labeling, and report candidate sentence generation processing using these two processing results.
  • Lung nodules may indicate some disease, and the results of lung nodule detection to detect the location of the lung nodules are often referred to early in the diagnostic workflow.
  • lung segment labeling is a function that divides the lung region so that it can be easily distinguished, and is often referred to after the result of lung nodule detection, and if there are no abnormal findings in the lung field image. , It may not be necessary to include the name of the lung region in detail in the report, and the results of lung segment labeling may not be referenced.
  • the report candidate sentence generation process is a process of generating a candidate of the finding sentence to be described in the report.
  • the report candidate sentence generation function generates candidates for findings by inputting the results of lung nodule detection and lung segment labeling, but even if there are no findings candidates, the results of lung nodule detection and lung segment labeling can be obtained.
  • the relationship between the priorities of each of the three processes can be determined as "lung nodule detection> lung area labeling> report candidate sentence generation”.
  • the image processing automatic request unit 208 can perform processing such as giving priority to a processing request for detecting a lung nodule.
  • the report candidate sentence generation process is an example of the "report creation support process" in the present disclosure.
  • the image processing automatic request unit 208 periodically grasps the load status of the image processing API server 30 performed in step S15.
  • the image processing automatic request unit 208 must internally send a processing request, but internally holds a processing request (for example, a bone labeling processing request) that cannot be sent due to its low priority. is doing.
  • the pending image processing request is transmitted after a certain period of time has elapsed.
  • the value of this timeout time may be given as a fixed value as a setting file or the like.
  • the image processing automatic request unit 208 is an average of the operation logs collected by the operation log collection unit 204 for the interpretation workflow.
  • the time-out time may be dynamically set based on the calculated time.
  • a dynamic setting may be made to set 60 minutes as the timeout period.
  • FIG. 3 is a flowchart showing an example of the operation related to the priority calculation.
  • the user 60 refers to various image processing results using the viewer 202 and performs a diagnostic workflow (step S51 of FIG. 3).
  • the operation log collection unit 204 collects the operation log of the operation of the viewer 202 by the user 60 (step S52).
  • the priority information update management unit 206 acquires the information necessary for the priority calculation of the processing request from the operation log (step S53).
  • the priority information update management unit 206 provides, for example, a log regarding the number of times the processing result is referenced and information on the reference order such as which processing result is referenced and then which processing result is referenced. get.
  • the priority information update management unit 206 that has acquired the necessary information calculates the priority of each process using the information in the procedure [3] (step S54).
  • the process here is a process of requesting the image processing API server 30 from the image processing automatic request unit 208 in each medical institution, for example, lung nodule detection. In the calculation of priority, for example, the following priority criteria are applied.
  • the subsequent priority calculation method may be passed as a setting file to the information processing device in which the priority information update management unit 206 is constructed, or may be directly implemented as a source code. ..
  • the above "priority standard" raises the priority of processing in which the result is frequently referred to, but it is also preferable to consider the following criteria as priority criteria other than the number of references. That is, it is considered necessary to raise the priority of the processing required as the pre-stage of other processing, such as the CADe-based processing, which is the pre-stage processing of the CADx-based processing.
  • the CADx-based process is a process for performing property analysis, and corresponds to, for example, a process for discriminating (differentiating) whether it is cancer or pneumonia.
  • the CADe system processing is a detection system processing that detects a specific area or target from the image, for example, a processing that detects whether an abnormal area is on the image and extracts an abnormal area. Corresponds to. When an abnormal region is detected by the CADe system processing, a stepwise processing mode in which the property analysis is performed by the CADx system processing can be considered.
  • the default priority value is given as an attribute to the priority value of various processes, and the result reference.
  • the number of times may be given as an addition value to the default value.
  • priority 200 is given as a default priority value for CADe-based processing
  • priority 100 is given as an attribute for CADx-based processing
  • the number of references to the result specified from the operation log is the default.
  • the process A may be, for example, an abnormal region extraction process in the lung
  • the process B may be, for example, a lung cancer AI determination process
  • the process C may be, for example, a pneumonia AI determination process
  • the process D may be, for example, a bronchitis AI determination process. ..
  • the abnormal region extraction process in the lung is an example of "CADe treatment” in the present disclosure
  • each of the lung cancer AI judgment process, the pneumonia AI judgment process, and the bronchitis AI judgment process is an example of "CADx treatment” in the present disclosure. Is.
  • the priority information calculated in step S54 (procedure [3] in FIG. 1) is stored in the priority information update management unit 206 (step S55).
  • the image processing automatic request unit 208 acquires the latest priority information of each process before sending the image processing process request at the timings such as step S16 and step S17 described with reference to FIG.
  • FIG. 4 is a diagram schematically showing a system configuration example of the medical image processing system 10.
  • a medical institution network 100 having the same system configuration is constructed in each of a plurality of medical institutions for the sake of simplicity, but the medical institution network having a different system configuration for each medical institution is shown. May be constructed.
  • the medical institution network 100 is a computer network including a modality 40, a DICOM server 50, an image processing management terminal 20A, a viewer terminal 22, an electronic medical record system 24, and a premises communication line 26.
  • the network 100 in the medical institution may include a plurality of types of modality 40. There may be various combinations of modality 40 types connected to the medical institution network 100 for each medical institution.
  • the DICOM server 50 communicates with other devices via the premises communication line 26, and transmits / receives various data including image data.
  • the DICOM server 50 receives image data and other various data generated by the modality 40 via the premises communication line 26, and stores and manages the data in a recording medium such as a large-capacity external storage device.
  • the storage format of the image data and the communication between the devices via the premises communication line 26 are based on the DICOM protocol.
  • the image processing management terminal 20A is an information processing device corresponding to the terminal 20 described with reference to FIG.
  • the form of the image processing management terminal 20A is not particularly limited, and may be a personal computer, a workstation, a tablet terminal, or the like.
  • the image processing management terminal 20A has a communication function for communicating with the image processing API server 30, and is connected to the image processing API server 30 via the wide area communication line 120.
  • the image processing management terminal 20A can acquire data from the DICOM server 50 or the like via the premises communication line 26. Further, the image processing management terminal 20A can send the processing result acquired from the image processing API server 30 to the DICOM server 50 and the viewer terminal 22.
  • the image processing management terminal 20A may also be used as the viewer terminal 22.
  • Various data stored in the database of the DICOM server 50 and various information including the processing result acquired by the image processing management terminal 20A can be displayed on the viewer terminal 22.
  • the viewer terminal 22 is a terminal for viewing images called a PACS viewer or a DICOM viewer.
  • a plurality of viewer terminals 22 may be connected to the medical institution network 100.
  • the form of the viewer terminal 22 is not particularly limited, and may be a personal computer, a workstation, a tablet terminal, or the like.
  • a network within a medical institution having a similar system configuration is constructed in each of a plurality of medical institutions.
  • the image processing API server 30 communicates with the image processing management terminal 20A of each medical institution via the wide area communication line 120.
  • the wide area communication line 120 is an example of the "network" in the present disclosure.
  • the image processing API server 30 can perform a plurality of image processing, and provides various image processing services in response to a processing request from the image processing management terminal 20A.
  • Image processing The image processing provided by the API server 30 includes, for example, a fracture detection process for detecting the position of a fracture, a bone labeling process for labeling bone numbers, a lung nodule detection process for detecting the position of a lung nodule, and a lung nodule.
  • the lung nodule property differentiation process for differentiating the properties of the lung nodule, and the labeling of the lung area may include at least one process of the lung area labeling process.
  • Image processing The image processing provided by the API server 30 also includes organ segmentation processing, blood vessel region extraction processing, brain CAD processing, breast CAD processing, liver CAD processing, large intestine CAD processing, and report creation support processing. sell.
  • FIG. 5 is a block diagram showing a configuration example of the image processing API server 30.
  • the image processing API server 30 can be realized by a computer system configured by using one or a plurality of computers. By installing a program on the computer, various functions of the image processing API server 30 are realized.
  • the image processing API server 30 includes a processor 302, a non-temporary tangible computer-readable medium 304, a communication interface 306, an input / output interface 308, a bus 310, an input device 314, and a display device 316.
  • the processor 302 is an example of the "first processor” in the present disclosure.
  • the computer-readable medium 304 is an example of the "first storage device” in the present disclosure.
  • the processor 302 includes a CPU (Central Processing Unit).
  • the processor 302 may include a GPU (Graphics Processing Unit).
  • the processor 302 is connected to the computer-readable medium 304, the communication interface 306, and the input / output interface 308 via the bus 310.
  • the input device 314 and the display device 316 are connected to the bus 310 via the input / output interface 308.
  • the computer-readable medium 304 includes a memory as a main storage device and a storage as an auxiliary storage device.
  • the computer-readable medium 304 may be, for example, a semiconductor memory, a hard disk (HDD: Hard Disk Drive) device, a solid state drive (SSD: Solid State Drive) device, or a combination thereof.
  • HDD Hard Disk Drive
  • SSD Solid State Drive
  • the image processing API server 30 is connected to the wide area communication line 120 (see FIG. 4) via the communication interface 306.
  • the computer-readable medium 304 stores a plurality of programs, data, and the like for performing various processes including a plurality of image processes.
  • the computer-readable medium 304 includes, for example, an organ segmentation program 320, a vascular region extraction program 322, a fracture CAD program 324, a bone labeling program 326, a lung nodule detection program 330, a lung nodule property analysis program 332, a pneumonia CAD program 334, and a lung area.
  • One or more of the labeling program 336, the breast CAD program 340, the liver CAD program 342, the brain CAD program 344, the colon CAD program 346, the report creation support program 348, and the like may be stored.
  • the report creation support program 348 includes a finding sentence candidate generation program 349.
  • These various processing programs may be AI processing modules including trained models trained to apply machine learning such as deep learning to obtain the output of the desired task.
  • the AI model for CAD can be configured by using, for example, various convolutional neural networks (CNN: Convolutional Neural Network) having a convolutional layer.
  • the input data for the AI model includes, for example, a medical image such as a two-dimensional image, a three-dimensional image or a moving image, and the output from the AI model is, for example, information indicating the position of a diseased area (lesion site) in the image, or It may be information indicating a classification such as a disease name, or a combination thereof.
  • An AI model that handles time-series data, document data, etc. can be configured using, for example, various recurrent neural networks (RNNs).
  • the time series data includes, for example, ECG waveform data.
  • Document data includes, for example, findings created by a doctor.
  • Each of the processing programs illustrated in FIG. 5 is an example of the "processing module” in the present disclosure.
  • Each of the fracture CAD program 324 and the lung nodule detection program 330 is an example of the "CADe module” in the present disclosure.
  • Each of the lung nodule property analysis program 332 and the pneumonia CAD program 334 is an example of the "CADx module” in the present disclosure.
  • the types and combinations of processing programs implemented in the image processing API server 30 can have various forms.
  • a server program including various processing programs stored in the computer-readable medium 304 is an example of the "first program" in the present disclosure.
  • the computer of the image processing API server 30 functions as a processing unit corresponding to the processing program.
  • the computer of the image processing API server 30 functions as an organ segmentation processing unit that performs organ segmentation processing. The same applies to other programs.
  • the processor 302 receives the image to be processed and the processing request from the image processing management terminal 20A of each medical institution by executing the instruction of the program stored in the computer-readable medium 304, and performs image processing corresponding to the processing request. Is executed and the processing result is returned to the request source.
  • the operation executed by the image processing API server 30 is an example of the "first operation" in the present disclosure.
  • the display control program 350 is stored in the computer-readable medium 304.
  • the display control program 350 generates a display signal necessary for display output to the display device 316, and controls the display of the display device 316.
  • the display device 316 is composed of, for example, a liquid crystal display, an organic EL (organic electro-luminescence: OEL) display, a projector, or an appropriate combination thereof.
  • the input device 314 is composed of, for example, a keyboard, a mouse, a touch panel, or other pointing device, a voice input device, or an appropriate combination thereof.
  • the input device 314 accepts various inputs by the operator.
  • the display device 316 and the input device 314 may be integrally configured by using the touch panel.
  • FIG. 6 is a block diagram showing a configuration example of the image processing management terminal 20A on the network 100 in the medical institution.
  • the image processing management terminal 20A can be realized by a computer system configured by using one or a plurality of computers.
  • the image processing management terminal 20A includes a processor 212, a non-temporary tangible computer readable medium 214, a communication interface 216, an input / output interface 218, a bus 220, an input device 224, and a display device 226.
  • the hardware configuration of the image processing management terminal 20A may be the same as the hardware configuration of the image processing API server 30 described with reference to FIG. That is, the hardware configurations of the processor 212, the computer readable medium 214, the communication interface 216, the input / output interface 218, the bus 220, the input device 224, and the display device 226 shown in FIG. 6 are the same as the corresponding elements shown in FIG. It may be.
  • the processor 212 is an example of the “second processor” and the “processor” in the present disclosure.
  • the computer-readable medium 214 is an example of the “second storage device” and the “storage device” in the present disclosure.
  • the image processing management terminal 20A is connected to the viewer terminal 22, the DICOM server 50, and the image processing API server 30 via the communication interface 216.
  • the computer-readable medium 214 stores various programs and data including the medical image processing request optimization program 200 and the display control program 260.
  • the medical image processing request optimization program 200 includes an operation log collection unit 204, a priority information update management unit 206, and an image processing automatic request unit 208.
  • the computer-readable medium 214 has an operation log database 205 that stores and manages operation log data collected by the operation log collection unit 204, and an image processing result acquired by the image processing automatic request unit 208 from the image processing API server 30. Includes a processing result storage unit 264 for storing the data.
  • the display control program 260 generates a display signal necessary for display output to the display device 226, and controls the display of the display device 226.
  • the processor 212 collects the operation log of the viewer terminal 22 by executing the instruction of the medical image processing request optimization program 200 stored in the computer readable medium 214, and based on the collected operation log, each Calculate the priority of image processing, record the priority information obtained by the calculation, update and manage the priority information of each image processing, and create a new image taken by modality 40. To acquire, to determine what image processing can be executed for the acquired new image, to grasp the load status of the image processing API server 30, and to determine the determined executable image processing. Based on each priority of the above and the load status of the image processing API server 30, an operation including sending a processing request to the image processing API server 30 according to the priority standard is performed.
  • the operation executed by the image processing management terminal 20A is an example of the "second operation" in the present disclosure.
  • the medical image processing request optimization program 200 is an example of the "second program" and the "program" in the present disclosure. Although an example of constructing an operation log collection unit 204, a priority information update management unit 206, and an image processing automatic request unit 208 in one image processing management terminal 20A is shown here, medical image processing request optimization is shown.
  • the processing function of the program 200 may be realized by sharing the processing function among two or more computers.
  • FIG. 7 is a block diagram showing a configuration example of the viewer terminal 22.
  • the hardware configuration of the viewer terminal 22 may be the same as the hardware configuration of the image processing management terminal 20A described with reference to FIG.
  • the viewer terminal 22 includes a processor 232, a computer-readable medium 234, a communication interface 236, an input / output interface 238, a bus 240, an input device 244, and a display device 246.
  • Each hardware configuration may be similar to the corresponding element of the configuration shown in FIG.
  • the computer-readable medium 234 includes a viewer 202, which is a medical image viewing program, an operation log storage unit 203 for storing the operation log of the viewer 202, and a display control program 262.
  • the viewer 202 causes the display device 246 to display various information including the image read from the DICOM server 50 connected via the communication interface 236 and the processing result of the image processing. Further, the viewer 202 saves the history (operation log) in which the user 60 operates the input device 244 in the operation log storage unit 203.
  • the operation log data saved in the operation log storage unit 203 is sent to the operation log collection unit 204 of the image processing management terminal 20A.
  • the display control program 262 generates a display signal necessary for display output to the display device 246, and controls the display of the display device 246.
  • FIG. 8 is a block diagram showing an example of a computer hardware configuration.
  • the computer 800 may be a personal computer, a workstation, or a server computer.
  • the computer 800 has a part or all of the terminal 20, the image processing API server 30, the DICOM server 50, the electronic medical record system 24, the image processing management terminal 20A, and the viewer terminal 22 described above, or a plurality of functions thereof. It can be used as a equipped device.
  • the computer 800 includes a CPU 802, a RAM (RandomAccessMemory) 804, a ROM (ReadOnlyMemory) 806, a GPU 808, a storage 810, a communication unit 812, an input device 814, a display device 816, and a bus 818.
  • the GPU 808 may be provided as needed.
  • the CPU 802 reads various programs stored in the ROM 806, the storage 810, or the like, and executes various processes.
  • the RAM 804 is used as a work area of the CPU 802. Further, the RAM 804 is used as a storage unit for temporarily storing the read program and various data.
  • the storage 810 includes, for example, a hard disk device, an optical disk, a magneto-optical disk, or a semiconductor memory, or a storage device configured by using an appropriate combination thereof.
  • Various programs, data, and the like are stored in the storage 810.
  • the program stored in the storage 810 is loaded into the RAM 804, and the CPU 802 executes the program, so that the computer 800 functions as a means for performing various processes specified by the program.
  • the communication unit 812 is an interface that performs communication processing with an external device by wire or wirelessly and exchanges information with the external device.
  • the communication unit 812 can play the role of an information acquisition unit that accepts input such as an image.
  • the input device 814 is an input interface that accepts various operation inputs to the computer 800.
  • the input device 814 may be, for example, a keyboard, mouse, touch panel, or other pointing device, or voice input device, or any combination thereof.
  • the display device 816 is an output interface for displaying various information.
  • the display device 816 may be, for example, a liquid crystal display, an organic electro-luminescence (OEL) display, a projector, or an appropriate combination thereof.
  • OEL organic electro-luminescence
  • a program that enables a computer to realize a part or all of at least one of the processing functions of the above is recorded on a computer-readable medium such as an optical disk, a magnetic disk, or a semiconductor memory or other tangible non-temporary information storage medium.
  • a computer-readable medium such as an optical disk, a magnetic disk, or a semiconductor memory or other tangible non-temporary information storage medium.
  • program signal as a download service using a telecommunication line such as the Internet, instead of storing and providing the program in such a tangible non-temporary computer-readable medium.
  • each processing unit executes various processes such as the operation log collection unit 204, the priority information update management unit 206, and the image processing automatic request unit 208 in the terminal 20 and the image processing management terminal 20A is For example, various processors as shown below.
  • CPU which is a general-purpose processor that executes programs and functions as various processing units
  • GPU which is a processor specialized in image processing
  • FPGA Field Programmable Gate Array
  • a dedicated electric circuit that is a processor with a circuit configuration specially designed to execute a specific process such as a programmable logic device (PLD) or ASIC (Application Specific Integrated Circuit), which is a processor that can change the CPU. Etc. are included.
  • PLD programmable logic device
  • ASIC Application Specific Integrated Circuit
  • One processing unit may be composed of one of these various processors, or may be composed of two or more processors of the same type or different types.
  • one processing unit may be configured by a plurality of FPGAs, a combination of a CPU and an FPGA, or a combination of a CPU and a GPU.
  • a plurality of processing units may be configured by one processor.
  • one processor is configured by a combination of one or more CPUs and software, as represented by a computer such as a client or a server. There is a form in which the processor functions as a plurality of processing units.
  • SoC System On Chip
  • the various processing units are configured by using one or more of the above-mentioned various processors as a hardware-like structure.
  • the hardware-like structure of these various processors is, more specifically, an electric circuit (circuitry) in which circuit elements such as semiconductor elements are combined.
  • the image processing system 10 According to the medical image processing system 10 according to the present embodiment, after the image is taken by the modality 40, the image processing result highly necessary for the user 60 can be viewed in a short time, so that the efficiency of the diagnostic work is high. Can be achieved.
  • Medical image processing system 20 Terminal 20A Image processing management terminal 22 Viewer terminal 24 Electronic chart system 26 On-site communication line 30 Image processing API server 40 Modality 50 DICOM server 60 User 100 Medical institution network 120 Wide area communication line 200 Medical image processing request Optimization program 202 Viewer 203 Operation log storage unit 204 Operation log collection unit 205 Operation log database 206 Priority information update management unit 208 Image processing automatic request unit 212 Processor 214 Computer readable medium 216 Communication interface 218 Communication interface 218 Input / output interface 220 Bus 224 Input device 226 Display device 232 Processor 234 Computer-readable medium 236 Communication interface 238 Input / output interface 240 Bus 244 Input device 246 Display device 260 Display control program 262 Display control program 264 Processing result storage unit 302 Processor 304 Computer-readable medium 306 Communication interface 308 Input / output interface 310 Bus 314 Input device 316 Display device 320 Organ segmentation program 322 Vascular region extraction program 324 Fracture CAD program 326 Bone labeling program 330 Pulmonary nodule detection

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Abstract

Provided are a medical image processing system, a medical image processing method, an information processing device, and a program with which system stability and usability can be ensured. In the present invention, an image processing server that performs a plurality of image processes receives an image to be processed and a processing request from the information processing device connected via a network, performs an image process corresponding to the processing request, and returns a processing result to the requestor. The information processing device collects operation logs of an image viewer on a medical institution internal network, calculates the respective priorities of the plurality of image processes on the basis of the collected operation logs, and updates and manages priority information. The information processing device obtains a new image imaged by one or more modalities, discriminates the image processes that can be executed on the obtained image, and transmits a processing request to the image processing server according to priority criteria on the basis of the respective priorities of the executable image processes and the load status of the image processing server.

Description

医用画像処理システム、医用画像処理方法、情報処理装置およびプログラムMedical image processing system, medical image processing method, information processing device and program
 本発明は医用画像処理システム、医用画像処理方法、情報処理装置およびプログラムに係り、特に画像処理サーバが処理対象の画像と処理要求とを受け取り、処理要求に応じた処理を実行して処理結果を要求元に返す医用画像処理サービスの提供に好適な医用画像処理技術に関する。 The present invention relates to a medical image processing system, a medical image processing method, an information processing apparatus, and a program, and in particular, an image processing server receives an image to be processed and a processing request, executes processing according to the processing request, and obtains a processing result. The present invention relates to a medical image processing technique suitable for providing a medical image processing service returned to a requester.
 医療分野においては、CT(Computed Tomography)装置およびMRI(Magnetic Resonance Imaging)装置等の画像診断装置の進歩により、質の高い高解像度の医用画像を用いての画像診断が可能となってきている。特に、近年は深層学習により学習がなされたニューラルネットワークを利用した人工知能(Artificial Intelligence:AI)を用いることにより、画像から病変領域などを認識したり、病名などの分類を特定したりするための解析処理の精度が向上している。 In the medical field, advances in diagnostic imaging equipment such as CT (Computed Tomography) equipment and MRI (Magnetic Resonance Imaging) equipment have made it possible to perform diagnostic imaging using high-quality, high-resolution medical images. In particular, in recent years, by using artificial intelligence (AI) that uses neural networks learned by deep learning, it is possible to recognize lesion areas from images and identify classifications such as disease names. The accuracy of the analysis process is improved.
 このようなコンピュータ支援診断(Computer Aided Diagnosis, Computer Aided Detection:CAD)等の解析処理は、例えば、肺、心臓、肝臓および脳等の部位毎に、さらには検出可能な病変毎に用意されることが多い。また、CADに留まらず、読影レポートなどにおける所見文の候補を自動生成するレポート作成支援処理を行うAI処理モジュールも開発されている。 Analysis processing such as computer-aided diagnosis (CAD) should be prepared for each site such as lung, heart, liver and brain, and for each detectable lesion. There are many. In addition to CAD, AI processing modules that perform report creation support processing that automatically generates candidate findings in interpretation reports and the like have also been developed.
 特許文献1には、各種の医用画像解析を行う画像処理プログラムにおいて、割り当てられた計算資源内で各種解析処理に対してCPU(Central Processing Unit)およびメモリ等の計算資源の割当を最適化する仕組みが提案されている。 Patent Document 1 describes a mechanism for optimizing the allocation of computational resources such as a CPU (Central Processing Unit) and memory for various analysis processes within the allocated computational resources in an image processing program that performs various medical image analysis. Has been proposed.
 また、特許文献2には、医用画像の画像保管通信システム(Picture Archiving and Communication System:PACS)において、画像診断装置を用いて撮影された医用画像を保管および/または通信する処理を最適化する方法が提案されている。 Further, Patent Document 2 describes a method of optimizing a process of storing and / or communicating a medical image taken by using an image diagnostic apparatus in a medical image storage communication system (Picture Archiving and Communication System: PACS). Has been proposed.
国際公開第2020/158100号International Publication No. 2020/158100 特開2005-218847号公報Japanese Unexamined Patent Publication No. 2005-218847
 医用画像に対する各種の解析処理は、各医療機関の医療機関内ネットワークに存在するサーバまたは端末において実施する構成を採用することも可能であるが、近年、画像処理API(Application Programming Interface)サーバを用いて、複数の医療機関からそれぞれの医療機関内に保存された医用画像と処理要求とを受け取り、処理結果を要求元に返す医用画像処理サービスが提供されている。例えば、肺CADなど各種医用画像処理機能を画像処理APIサーバから提供することが行われている。肺CADは、例えば、肺のCT画像を入力データに用い、肺疾患領域の検出および/または疾患名(病名)の認識結果などを出力する学習済みのAIモデルを利用したAI処理モジュールを含む。 It is possible to adopt a configuration in which various analysis processes for medical images are performed on a server or terminal existing in the network in the medical institution of each medical institution, but in recent years, an image processing API (Application Programming Interface) server has been used. Therefore, a medical image processing service that receives medical images and processing requests stored in each medical institution from a plurality of medical institutions and returns the processing results to the request source is provided. For example, various medical image processing functions such as lung CAD are provided from an image processing API server. The lung CAD includes, for example, an AI processing module using a trained AI model that uses a CT image of a lung as input data and outputs a detection result of a lung disease region and / or a recognition result of a disease name (disease name).
 このような医用画像処理サービスを利用する各医療機関において、様々な種類の医用画像の処理結果を読影業務等の診断ワークフローにできるだけ早く利用していくためには、CT装置等のモダリティによる検査の撮影から医用画像処理結果の出力までの時間をできるだけ短縮することが求められている。 In each medical institution that uses such a medical image processing service, in order to use the processing results of various types of medical images in a diagnostic workflow such as image interpretation work as soon as possible, inspection by a modality such as a CT device is performed. It is required to shorten the time from shooting to output of medical image processing results as much as possible.
 かかる要求に対応するためには、モダリティにて画像が撮影され次第、自動的に画像がDICOM(Digital Imaging and Communication in Medicine)サーバ等から取得され、その画像に対して可能な処理を自動的に実行する機能が必要である。この際、自動的に取得された画像が、画像処理の自動実行条件に当てはまるもの全てに対して処理要求が行われるようになっていると、以下のような問題を生む。 In order to respond to such a request, as soon as an image is taken by modality, the image is automatically acquired from a DICOM (Digital Imaging and Communication in Medicine) server, etc., and possible processing for the image is automatically performed. You need the ability to do it. At this time, if the automatically acquired image is such that a processing request is made for all the images that meet the automatic execution conditions of image processing, the following problems occur.
 [課題1]例えば、オンプレミスまたはクラウド上に展開した画像処理APIなど、処理要求を投げる先(処理要求先)に対して、医療機関側の端末から処理要求を投げることになるが、処理要求先の計算資源(リソース)が逼迫しているにも関わらず、自動実行条件に当てはまるもの全ての処理要求を投げていくと、優先度の低い処理結果を得るための計算に処理要求先のリソースが圧迫され、優先度の高い処理がなかなか実行されない可能性がある。ここでいう優先度の低い処理結果とは、例えば、実際の診断ワークフローにおいて余り使われない画像処理結果などをいう。 [Problem 1] For example, a processing request is thrown from a terminal on the medical institution side to a destination (processing request destination) to which a processing request is thrown, such as an image processing API deployed on-premises or on the cloud. Even though the computational resources (resources) of are tight, if all the processing requests that meet the automatic execution conditions are thrown, the resource of the processing request destination will be used for the calculation to obtain the low priority processing result. It may be oppressed and high priority processing may not be executed easily. The low-priority processing result here means, for example, an image processing result that is rarely used in an actual diagnostic workflow.
 [課題2]課題1に対して、例えば、処理要求を投げる側で処理要求を投げる際に、高/中/低などの優先度を設定して処理要求を投げることにより、処理要求先にて優先度の高いものから処理させていくということも考えられる。しかしながら、利用者側で自身の診断ワークフローがスムーズに終わるよう最適な優先度を決めることは困難である。また、柔軟な優先度設定のためには優先度の粒度が3段階より多く必要となることも想定され、利用者による優先度決めはさらに困難になる。このため、システム的に優先度を最適化する仕組みが望まれる。 [Problem 2] For Problem 1, for example, when a processing request is thrown by the side throwing the processing request, a priority such as high / medium / low is set and the processing request is thrown at the processing request destination. It is also conceivable to process the items with the highest priority. However, it is difficult for users to determine the optimum priority so that their diagnostic workflow can be completed smoothly. Further, it is assumed that the particle size of the priority is required to be more than three stages for flexible priority setting, and it becomes more difficult for the user to decide the priority. Therefore, a mechanism for systematically optimizing the priority is desired.
 [課題3]システム障害等で処理要求を受け付ける側のオンプレミスサーバまたはクラウドサーバのリソースが通常よりも少なくなっている場合は、通常よりもさらに処理要求側から投げる処理要求を通常時と比較して少なくするなどの調整を行わないと、必要としている処理結果が長時間経っても返ってこないなど、ユーザビリティを著しく損なう可能性がある。画像処理API側のリソース保護のために、APIのレイトリミット(rate limit)を設定しているような場合も、上記と同じ様な調整を行う必要性が生じる。 [Problem 3] When the resources of the on-premises server or cloud server on the side that receives the processing request are less than usual due to a system failure or the like, the processing request thrown from the processing request side is compared with the normal time. If adjustments such as reduction are not made, the required processing results may not be returned even after a long period of time, which may significantly impair usability. Even when the late limit (rate limit) of the API is set for resource protection on the image processing API side, it is necessary to make the same adjustment as described above.
 つまり、画像処理を行うサーバ側の負荷状況を無視してクライアント端末側から処理要求を投げ続けてしまうことで、サーバ側の動作が不安定になったり、クライアント端末側で最低限必要な処理結果の取得にも長時間の待ち時間が発生してしまったりする。 In other words, by ignoring the load status on the server side that performs image processing and continuing to throw processing requests from the client terminal side, the operation on the server side becomes unstable or the minimum required processing result on the client terminal side. There may be a long waiting time for the acquisition.
 本開示はこのような事情に鑑みてなされたものであり、上記の複数の課題の少なくとも1つを解決し、システムの安定性およびユーザビリティを確保することができる医用画像処理システム、医用画像処理方法、情報処理装置およびプログラムを提供することを目的とする。本開示は、モダリティで撮影された新たな画像に対して自動的に処理要求を行うクライアント端末側において、処理要求を投げる際に、要求する処理の優先順位を動的に決定することによって処理要求数自体を有効的に絞り、クライアント端末側において最低限必要とされている処理結果(優先度の高い処理結果)ができるだけ早く返ってくるようにするための仕組みを提案する。 The present disclosure has been made in view of such circumstances, and is a medical image processing system and a medical image processing method capable of solving at least one of the above-mentioned plurality of problems and ensuring the stability and usability of the system. , Information processing equipment and programs are provided. The present disclosure is a processing request by dynamically determining the priority of the requested processing when the processing request is thrown on the client terminal side that automatically requests the processing for a new image taken by the modality. We propose a mechanism to effectively narrow down the number itself and return the minimum required processing results (high-priority processing results) on the client terminal side as soon as possible.
 本開示の一態様に係る医用画像処理システムは、医用画像の画像処理を行う画像処理サーバと、画像処理サーバにネットワークを介して接続される情報処理装置とを含む医用画像処理システムであって、画像処理サーバは、1つ以上の第1のプロセッサを備え、第1のプロセッサは、複数の画像処理を行うための複数の処理モジュールを実行し、情報処理装置から処理対象の画像と処理要求とを受け取り、処理要求に対応した画像処理を実施して処理結果を要求元に返す、情報処理装置は、1つ以上の第2のプロセッサを備え、第2のプロセッサは、情報処理装置が接続される医療機関内ネットワーク上で利用者が画像処理の処理結果を閲覧する際に用いられる画像ビューワの操作ログを収集し、収集した操作ログを基に、複数の画像処理のそれぞれの優先度を計算し、計算によって得られた優先度の情報を記録し、複数の画像処理のそれぞれの優先度情報の更新および管理を行い、医療機関内ネットワークに接続された1つ以上のモダリティによって撮影された新たな画像を取得し、取得された新たな画像に対して、複数の画像処理のうち何の画像処理を実行できるかを判別し、画像処理サーバの負荷状況を把握し、判別された実行可能な1つ以上の画像処理のそれぞれの優先度と、把握された画像処理サーバの負荷状況とに基づき、画像処理サーバに対して優先度の基準に従い、実行可能な1つ以上の画像処理の処理要求を送信する。 The medical image processing system according to one aspect of the present disclosure is a medical image processing system including an image processing server that performs image processing of medical images and an information processing device connected to the image processing server via a network. The image processing server includes one or more first processors, in which the first processor executes a plurality of processing modules for performing a plurality of image processes, and the information processing apparatus determines the image to be processed and the processing request. Is received, image processing corresponding to the processing request is performed, and the processing result is returned to the request source. The information processing apparatus includes one or more second processors, and the second processor is connected to the information processing apparatus. Collects the operation log of the image viewer used when the user browses the processing result of image processing on the network in the medical institution, and calculates the priority of each of multiple image processing based on the collected operation log. It records the priority information obtained by the calculation, updates and manages the priority information of each of the multiple image processes, and is newly taken by one or more modalities connected to the network in the medical institution. Image processing can be performed for the acquired new image, which image processing can be executed among multiple image processes, the load status of the image processing server can be grasped, and the determined image processing can be performed. Based on the priority of each one or more image processing and the grasped load status of the image processing server, the processing request of one or more image processing that can be executed according to the priority standard to the image processing server. To send.
 本態様の医用画像処理システムによれば、処理要求を出す側の情報処理装置において、取得された画像に対する画像処理の処理要求を送る際に、画像処理サーバの負荷状況を把握させ、対象の画像について実行可能な画像処理ごとの優先度と、画像処理サーバの負荷状況とを勘案して、画像処理サーバに対して実際に要求する処理を決定することで、画像処理サーバへ送信する処理要求の数(処理要求の送信数)を制御する。 According to the medical image processing system of this embodiment, when the information processing apparatus on the side issuing the processing request sends a processing request for image processing to the acquired image, the load status of the image processing server is grasped and the target image is displayed. By determining the processing that is actually requested from the image processing server in consideration of the priority of each image processing that can be executed and the load status of the image processing server, the processing request to be sent to the image processing server can be determined. Control the number (number of processing requests sent).
 これにより、負荷状況に合わせて優先度の高い処理の処理要求が優先的に行われ、画像処理サーバのリソースが逼迫している状況の場合には、優先度の低い処理の処理要求が抑制される。各画像処理の優先度は、利用者が画像ビューワを用いて処理結果等を参照した際の操作ログを基に計算されるため、利用者にとって必要性の高い処理結果あるいは優先順位の高い処理結果を適切に決定することができる。本態様によれば、画像処理サーバのリソースが逼迫している状況であっても、優先度の高い処理結果を比較的早期に取得することができ、システム全体としての安定性および/または応答性を確保できる。 As a result, processing requests for high-priority processing are prioritized according to the load status, and when the resources of the image processing server are tight, processing requests for low-priority processing are suppressed. To. Since the priority of each image processing is calculated based on the operation log when the user refers to the processing result using the image viewer, the processing result that is highly necessary for the user or the processing result with high priority is calculated. Can be determined appropriately. According to this aspect, even in a situation where the resources of the image processing server are tight, the processing result with high priority can be acquired relatively early, and the stability and / or responsiveness of the entire system can be obtained. Can be secured.
 本開示の他の態様に係る医用画像処理システムにおいて、画像処理サーバは、複数の医療機関のそれぞれの情報処理装置からアクセスできるネットワーク上に設置される構成であってよい。 In the medical image processing system according to another aspect of the present disclosure, the image processing server may be configured to be installed on a network accessible from each information processing device of a plurality of medical institutions.
 本開示の他の態様に係る医用画像処理システムにおいて、ネットワークを介して画像処理サーバに接続される複数の情報処理装置を含み、複数の情報処理装置のそれぞれは、互いに異なる医療機関の医療機関内ネットワークに接続される端末を含む構成であってよい。 In the medical image processing system according to another aspect of the present disclosure, a plurality of information processing devices connected to an image processing server via a network are included, and each of the plurality of information processing devices is within a medical institution of a different medical institution. The configuration may include terminals connected to the network.
 本開示の他の態様に係る医用画像処理システムにおいて、医療機関内ネットワーク上には、1つ以上のモダリティによって撮影された画像を保存する画像保存サーバが設置される構成であってよい。 In the medical image processing system according to another aspect of the present disclosure, an image storage server for storing images taken by one or more modality may be installed on a network in a medical institution.
 本開示の他の態様に係る医用画像処理システムにおいて、情報処理装置は、操作ログから画像処理の処理結果の参照回数および参照順序の情報を取得し、参照回数および参照順序の情報を用いて各画像処理の優先度を計算する構成であってよい。 In the medical image processing system according to another aspect of the present disclosure, the information processing apparatus acquires information on the reference count and the reference order of the image processing processing result from the operation log, and uses the reference count and reference order information to be used for each. It may be configured to calculate the priority of image processing.
 本開示の他の態様に係る医用画像処理システムにおいて、情報処理装置は、画像ビューワを兼ねる構成であってよい。 In the medical image processing system according to another aspect of the present disclosure, the information processing device may be configured to also serve as an image viewer.
 本開示の他の態様に係る医用画像処理システムにおいて、医療機関内ネットワークには、複数の画像ビューワが接続され、情報処理装置は、複数の画像ビューワのそれぞれの操作ログを収集し、収集した複数の操作ログに記録された情報を統計処理することにより、優先度を計算する構成であってよい。 In the medical image processing system according to another aspect of the present disclosure, a plurality of image viewers are connected to the network in the medical institution, and the information processing apparatus collects and collects operation logs of the plurality of image viewers. The priority may be calculated by statistically processing the information recorded in the operation log of.
 本開示の他の態様に係る医用画像処理システムにおいて、情報処理装置は、取得された新たな画像に写っている臓器を抽出する臓器抽出処理を行い、抽出された臓器の情報に基づき、複数の画像処理の中から臓器に関連する画像処理を実行可能な画像処理として判別する構成であってよい。 In the medical image processing system according to another aspect of the present disclosure, the information processing apparatus performs an organ extraction process for extracting the organs shown in the acquired new image, and based on the information of the extracted organs, a plurality of organs are extracted. It may be configured to discriminate the image processing related to the organ from the image processing as the feasible image processing.
 本開示の他の態様に係る医用画像処理システムにおいて、情報処理装置は、取得された新たな画像に付されているタグ情報に基づき、複数の画像処理の中から実行可能な画像処理を判別する構成であってよい。 In the medical image processing system according to another aspect of the present disclosure, the information processing apparatus determines an image processing that can be performed from a plurality of image processings based on the tag information attached to the acquired new image. It may be a configuration.
 本開示の他の態様に係る医用画像処理システムにおいて、画像処理サーバは、情報処理装置からの負荷状況の問い合わせを受けて、現在の負荷状況を応答するエンドポイントを備え、情報処理装置は、エンドポイントを使用し、エンドポイントから画像処理サーバの負荷状況を示す情報を取得する構成であってよい。 In the medical image processing system according to another aspect of the present disclosure, the image processing server includes an endpoint that receives an inquiry about the load status from the information processing device and responds to the current load status, and the information processing device is an end. It may be configured to use points and acquire information indicating the load status of the image processing server from the endpoint.
 本開示の他の態様に係る医用画像処理システムにおいて、情報処理装置は、画像処理サーバに対して処理要求を送信してから処理結果が得られるまでの応答時間を処理要求ごとに記録し、応答時間の増加率を計算することにより、画像処理サーバの負荷状況を把握する構成であってよい。 In the medical image processing system according to another aspect of the present disclosure, the information processing apparatus records the response time from the transmission of the processing request to the image processing server until the processing result is obtained for each processing request, and responds. By calculating the rate of increase in time, the load status of the image processing server may be grasped.
 本開示の他の態様に係る医用画像処理システムにおいて、情報処理装置は、把握された画像処理サーバの負荷状況を示す数値を閾値と照らし合わせ、閾値に応じた優先度の処理の処理要求を画像処理サーバに送信する構成であってよい。 In the medical image processing system according to another aspect of the present disclosure, the information processing apparatus compares the grasped numerical value indicating the load status of the image processing server with the threshold value, and makes an image of the processing request for the processing of the priority according to the threshold value. It may be configured to send to the processing server.
 本開示の他の態様に係る医用画像処理システムにおいて、優先度は、最も低い優先度のレベルから最も高い優先度のレベルまでが50段階以上にレベル分けされている構成であってよい。 In the medical image processing system according to another aspect of the present disclosure, the priority may be divided into 50 or more levels from the lowest priority level to the highest priority level.
 本開示の他の態様に係る医用画像処理システムにおいて、複数の画像処理は、コンピュータ検出支援(Computer Aided Detection:CADe)の処理およびコンピュータ診断支援(Computer Aided Diagnosis:CADx)の処理のうち少なくとも1つの処理を含む構成であってよい。 In the medical image processing system according to another aspect of the present disclosure, the plurality of image processing is at least one of computer detection support (Computer Aided Detection: CADe) processing and computer diagnosis support (Computer Aided Diagnosis: CADx) processing. It may be a configuration including processing.
 本開示の他の態様に係る医用画像処理システムにおいて、複数の処理モジュールは、CADeの処理を行うCADeモジュールと、CADxの処理を行うCADxモジュールと、を含む構成であってよい。 In the medical image processing system according to another aspect of the present disclosure, the plurality of processing modules may be configured to include a CADe module that processes CADe and a CADx module that processes CADx.
 本開示の他の態様に係る医用画像処理システムにおいて、デフォルトの設定において、CADeの処理の優先度は、CADxの処理の優先度よりも高い優先度に設定される構成であってよい。 In the medical image processing system according to another aspect of the present disclosure, in the default setting, the CADe processing priority may be set to a higher priority than the CADx processing priority.
 本開示の他の態様に係る医用画像処理システムにおいて、複数の処理モジュールは、所見文の候補を生成する処理を含むレポート作成支援処理を行う処理モジュールを含む構成であってよい。 In the medical image processing system according to another aspect of the present disclosure, the plurality of processing modules may be configured to include a processing module that performs a report creation support process including a process of generating a candidate for a finding sentence.
 本開示の他の態様に係る医用画像処理システムにおいて、デフォルトの設定において、レポート作成支援処理の優先度は、CADeの処理の優先度およびCADxの処理の優先度よりも低い優先度に設定される構成であってよい。 In the medical image processing system according to another aspect of the present disclosure, in the default setting, the priority of the report creation support process is set to be lower than the priority of the CADe process and the priority of the CADx process. It may be a configuration.
 本開示の他の態様に係る医用画像処理システムにおいて、複数の画像処理は、骨折の位置を検出する骨折検出処理と、骨番号のラベリングを行う骨ラベリング処理と、肺結節の位置を検出する肺結節検出処理と、肺結節の性状を鑑別する性状鑑別処理と、肺区域のラベリングを肺区域ラベリング処理と、のうち少なくとも1つの処理を含む構成であってよい。 In the medical image processing system according to another aspect of the present disclosure, the plurality of image processing includes a fracture detection process for detecting the position of a fracture, a bone labeling process for labeling a bone number, and a lung for detecting the position of a lung nodule. It may be configured to include at least one of a nodule detection process, a property discrimination process for differentiating the properties of lung nodules, and a lung area labeling process for lung area labeling.
 本開示の他の態様に係る医用画像処理方法は、複数の画像処理を行うことができる画像処理サーバにネットワークを介して接続された情報処理装置から処理対象の画像と処理要求とを画像処理サーバに送り、画像処理サーバにて処理要求に対応した画像処理を実施して処理結果を要求元に返す医用画像処理方法であって、情報処理装置が接続される医療機関内ネットワーク上において利用者が画像処理の処理結果を閲覧する際に用いられる画像ビューワの操作ログを収集することと、収集した操作ログを基に、複数の画像処理のそれぞれの優先度を計算することと、計算によって得られた優先度の情報を記録し、複数の画像処理のそれぞれの優先度情報の更新および管理を行うことと、医療機関内ネットワークに接続された1つ以上のモダリティによって撮影された新たな画像を取得することと、取得された新たな画像に対して、複数の画像処理のうち何の画像処理を実行できるかを判別することと、画像処理サーバの負荷状況を把握することと、判別された実行可能な1つ以上の画像処理のそれぞれの優先度と、把握された画像処理サーバの負荷状況とに基づき、画像処理サーバに対して優先度の基準に従い、実行可能な1つ以上の画像処理の処理要求を行うことと、を含む。 In the medical image processing method according to another aspect of the present disclosure, an image processing server that processes an image to be processed and a processing request from an information processing apparatus connected to an image processing server capable of performing a plurality of image processing via a network. This is a medical image processing method in which the image processing server performs image processing corresponding to the processing request and returns the processing result to the request source. Obtained by collecting the operation log of the image viewer used when viewing the processing result of image processing, calculating the priority of each of multiple image processing based on the collected operation log, and calculating. It records the priority information, updates and manages the priority information of each of multiple image processes, and acquires new images taken by one or more modalities connected to the network in the medical institution. To do, to determine which image processing can be executed among multiple image processes for the acquired new image, to grasp the load status of the image processing server, and to execute the determined image. Based on the respective priorities of one or more possible image processing and the grasped load status of the image processing server, the image processing server is subject to the priority criteria of one or more image processing that can be performed. Including making a processing request.
 本開示の他の態様に係る情報処理装置は、複数の画像処理を行うことができる画像処理サーバにネットワークを介して接続される情報処理装置であって、1つ以上のプロセッサを備え、プロセッサは、情報処理装置が接続される医療機関内ネットワーク上で利用者が画像処理の処理結果を閲覧する際に用いられる画像ビューワの操作ログを収集し、収集した操作ログを基に、複数の画像処理のそれぞれの優先度を計算し、計算によって得られた優先度の情報を記録し、複数の画像処理のそれぞれの優先度情報の更新および管理を行い、医療機関内ネットワークに接続された1つ以上のモダリティによって撮影された新たな画像を取得し、取得された新たな画像に対して、複数の画像処理のうち何の画像処理を実行できるかを判別し、画像処理サーバの負荷状況を把握し、判別された実行可能な1つ以上の画像処理のそれぞれの優先度と、把握された画像処理サーバの負荷状況とに基づき、画像処理サーバに対して優先度の基準に従い、実行可能な1つ以上の画像処理の処理要求を送信する。 The information processing apparatus according to another aspect of the present disclosure is an information processing apparatus connected to an image processing server capable of performing a plurality of image processing via a network, and includes one or more processors. , Collect the operation log of the image viewer used when the user browses the processing result of image processing on the network in the medical institution to which the information processing device is connected, and based on the collected operation log, multiple image processing Calculate each priority of, record the priority information obtained by the calculation, update and manage each priority information of multiple image processing, and one or more connected to the network in the medical institution. Acquires a new image taken by the modality of, determines what image processing can be executed among multiple image processes for the acquired new image, and grasps the load status of the image processing server. , One that can be executed according to the priority criteria for the image processing server based on the priority of each of the determined one or more image processing that can be executed and the load status of the grasped image processing server. The processing request for the above image processing is transmitted.
 本開示の他の態様に係るプログラムは、複数の画像処理を行うことができる画像処理サーバにネットワークを介して接続される情報処理装置としてコンピュータを機能させるためのプログラムであって、コンピュータに、情報処理装置が接続される医療機関内ネットワーク上で利用者が画像処理の処理結果を閲覧する際に用いられる画像ビューワの操作ログを収集する機能と、収集した操作ログを基に、複数の画像処理のそれぞれの優先度を計算する機能と、計算によって得られた優先度の情報を記録し、複数の画像処理のそれぞれの優先度情報の更新および管理を行う機能と、医療機関内ネットワークに接続された1つ以上のモダリティによって撮影された新たな画像を取得する機能と、取得された新たな画像に対して、複数の画像処理のうち何の画像処理を実行できるかを判別する機能と、画像処理サーバの負荷状況を把握する機能と、判別された実行可能な1つ以上の画像処理のそれぞれの優先度と、把握された画像処理サーバの負荷状況とに基づき、画像処理サーバに対して優先度の基準に従い、実行可能な1つ以上の画像処理の処理要求を送信する機能と、を実現させるためのプログラムである。 The program according to another aspect of the present disclosure is a program for making a computer function as an information processing apparatus connected to an image processing server capable of performing a plurality of image processing via a network, and the computer is informed of information. Multiple image processing based on the function to collect the operation log of the image viewer used when the user browses the processing result of the image processing on the network in the medical institution to which the processing device is connected, and the collected operation log. A function to calculate each priority of the image, a function to record the priority information obtained by the calculation, and a function to update and manage the priority information of each of multiple image processes, and to be connected to the network in the medical institution. A function to acquire a new image taken by one or more modalities, a function to determine which image processing among a plurality of image processes can be executed for the acquired new image, and an image. Priority is given to the image processing server based on the function of grasping the load status of the processing server, the priority of each of the determined and executable image processing, and the grasped load status of the image processing server. It is a program for realizing a function of transmitting a processing request for one or more image processing that can be executed according to a standard of degree.
 本発明によれば、画像処理の処理要求を行う側の情報処理装置において、画像処理サーバの負荷状況と、各画像処理の優先度とに基づき、画像処理サーバに送る処理要求の数を有効的に絞り込むことができる。本発明によれば、処理要求に応じた画像処理の処理結果を提供する画像処理サーバの動作の安定性を確保できる。また、本発明に係る情報処理装置は、利用者にとって必要性の高い処理結果を早めに取得することが可能であり、ユーザビリティが確保される。 According to the present invention, in the information processing apparatus on the side that makes an image processing processing request, the number of processing requests sent to the image processing server is effective based on the load status of the image processing server and the priority of each image processing. Can be narrowed down to. According to the present invention, it is possible to ensure the stability of the operation of the image processing server that provides the processing result of the image processing according to the processing request. In addition, the information processing apparatus according to the present invention can quickly acquire processing results that are highly necessary for the user, and usability is ensured.
図1は、本発明の実施形態に係る医用画像処理システムの構成および動作を概略的に示すブロック図である。FIG. 1 is a block diagram schematically showing the configuration and operation of the medical image processing system according to the embodiment of the present invention. 図2は、図1に示す医用画像処理システムの動作の流れを示すフローチャートである。FIG. 2 is a flowchart showing the operation flow of the medical image processing system shown in FIG. 図3は、優先度計算に関する動作の例を示すフローチャートである。FIG. 3 is a flowchart showing an example of the operation related to the priority calculation. 図4は、医用画像処理システムのシステム構成例を概略的に示す図である。FIG. 4 is a diagram schematically showing a system configuration example of a medical image processing system. 図5は、画像処理APIサーバの構成例を示すブロック図である。FIG. 5 is a block diagram showing a configuration example of an image processing API server. 図6は、医療機関内ネットワーク上の画像処理管理端末の構成例を示すブロック図である。FIG. 6 is a block diagram showing a configuration example of an image processing management terminal on a network in a medical institution. 図7は、ビューワ端末の構成例を示すブロック図である。FIG. 7 is a block diagram showing a configuration example of a viewer terminal. 図8は、コンピュータのハードウェア構成の例を示すブロック図である。FIG. 8 is a block diagram showing an example of a computer hardware configuration.
 以下、添付図面に従って本発明の好ましい実施形態について説明する。 Hereinafter, preferred embodiments of the present invention will be described with reference to the accompanying drawings.
 《医用画像処理システムの概要》
 図1は、本発明の実施形態に係る医用画像処理システム10の構成および動作を概略的に示すブロック図である。医用画像処理システム10は、複数の医療機関のそれぞれの医療機関内ネットワーク上に設置される端末20と、各医療機関の端末20からアクセス可能なネットワーク上に設置される画像処理APIサーバ30とを含む。
<< Overview of medical image processing system >>
FIG. 1 is a block diagram schematically showing the configuration and operation of the medical image processing system 10 according to the embodiment of the present invention. The medical image processing system 10 comprises a terminal 20 installed on a network in each medical institution of a plurality of medical institutions and an image processing API server 30 installed on a network accessible from the terminal 20 of each medical institution. include.
 ここで端末20とは、安全に医療機関内のデータにアクセスできるネットワーク内に存在する計算資源を指しており、その端末20は物理的に医療機関内に存在しなくてもよい。各医療機関の端末20は、物理マシンであってもよいし、仮想マシンであってもよく、具体的な形態は限定されない。医療機関の代表的な例は「病院」である。図1に示す「病院1」、「病院2」・・・「病院N」の表示は、N個の医療機関が存在していることを表している。1つの医療機関について少なくとも1つの端末20が医療機関内ネットワーク上に設けられる。端末20は本開示における「情報処理装置」の一例である。 Here, the terminal 20 refers to a computational resource existing in a network that can safely access data in a medical institution, and the terminal 20 does not have to physically exist in the medical institution. The terminal 20 of each medical institution may be a physical machine or a virtual machine, and the specific form is not limited. A typical example of a medical institution is a "hospital". The indications of "hospital 1", "hospital 2" ... "hospital N" shown in FIG. 1 indicate that N medical institutions exist. At least one terminal 20 for one medical institution is provided on the medical institution network. The terminal 20 is an example of the "information processing device" in the present disclosure.
 画像処理APIサーバ30は、N個の医療機関のそれぞれの端末20から画像処理要求を受け取り、要求された画像処理を実行して処理結果を要求元に返す中央画像処理サーバである。 The image processing API server 30 is a central image processing server that receives an image processing request from each terminal 20 of N medical institutions, executes the requested image processing, and returns the processing result to the request source.
 各医療機関の医療機関内ネットワークには、1つ以上のモダリティ40と、DICOMサーバ50とが接続されている。モダリティ40は、検査画像を撮影する装置である。モダリティ40には、被写体の検査対象部位を撮影することにより、その部位を表す検査画像を生成し、その画像にDICOM規格で規定された付帯情報を付加して出力する装置が含まれる。モダリティ40の具体例としては、CT装置(Computed Tomography:コンピュータ断層撮影装置)、MRI装置(magnetic resonance imaging:磁気共鳴画像撮影装置)、血管造影X線診断装置、PET装置(Positron Emission Tomography:陽電子放射断層撮影装置)、超音波装置、平面X線検出器(Flat Panel Detector:FPD)を用いたCR装置(Computed Radiography:コンピュータX線撮影装置)、マンモグラフィ装置、および内視鏡装置等が挙げられる。 One or more modality 40s and a DICOM server 50 are connected to the medical institution network of each medical institution. Modality 40 is a device for taking an inspection image. The modality 40 includes a device that generates an inspection image representing the inspection target portion of the subject by photographing the inspection target portion, adds incidental information defined by the DICOM standard to the image, and outputs the inspection image. Specific examples of the modality 40 include a CT device (Computed Tomography), an MRI device (magnetic resonance imaging), an angiography X-ray diagnostic device, and a PET device (Positron Emission Tomography). Examples thereof include a tomography apparatus), an ultrasonic apparatus, a CR apparatus (Computed Radiography: computer X-ray imaging apparatus) using a flat X-ray detector (FPD), a mammography apparatus, and an endoscopic apparatus.
 DICOMサーバ50は、DICOMの仕様にて動作するサーバである。DICOMサーバ50は、モダリティ40を用いて撮影された画像を含む各種データを保存および管理するコンピュータであり、大容量外部記憶装置およびデータベース管理用プログラムを備えている。DICOMサーバ50は本開示における「画像保存サーバ」の一例である。 The DICOM server 50 is a server that operates according to the DICOM specifications. The DICOM server 50 is a computer that stores and manages various data including images taken by using the modality 40, and includes a large-capacity external storage device and a database management program. The DICOM server 50 is an example of the "image storage server" in the present disclosure.
 各医療機関において1つ以上の端末20上に、ビューワ202、操作ログ収集部204、優先度情報更新管理部206および画像処理自動要求部208のそれぞれが構築される。ビューワ202は、医師による画像診断の診断ワークフローを支援する読影ビューワプログラムを含む。ビューワ202は、検査画像や画像処理結果等を表示装置に表示させる。ビューワ202は専用の閲覧ソフトであってもよいし、Webブラウザなどであってもよい。ビューワ202は本開示における「画像ビューワ」の一例である。 In each medical institution, a viewer 202, an operation log collection unit 204, a priority information update management unit 206, and an image processing automatic request unit 208 are constructed on one or more terminals 20. Viewer 202 includes an image interpretation viewer program that assists the diagnostic workflow of diagnostic imaging by a physician. The viewer 202 causes the display device to display the inspection image, the image processing result, and the like. The viewer 202 may be dedicated browsing software, a Web browser, or the like. The viewer 202 is an example of the "image viewer" in the present disclosure.
 操作ログ収集部204は、利用者60がビューワ202を使用した際の操作ログを収集するプログラムである。操作ログ収集部204は、利用者60に操作ログの収集作業を意識させることなく、適宜のタイミングで操作ログを自動的に収集する。収集された操作ログのデータは操作ログデータベース(Data Base:DB)205に格納される。 The operation log collection unit 204 is a program that collects operation logs when the user 60 uses the viewer 202. The operation log collection unit 204 automatically collects operation logs at appropriate timings without making the user 60 aware of the operation log collection work. The collected operation log data is stored in the operation log database (DataBase: DB) 205.
 利用者60は、主に医師などであり、ビューワ202を利用して画像処理結果を参照する者である。 The user 60 is mainly a doctor or the like, and is a person who refers to the image processing result by using the viewer 202.
 優先度情報更新管理部206は、操作ログ収集部204によって収集された操作ログに基づいて、各種医用画像処理の優先順位を計算するプログラムである。優先度情報更新管理部206は、利用者60の個人ごとに取得された操作ログに基づいて個人別に優先順位を計算してもよいし、複数の利用者60の操作ログを統計処理して医療機関内における平均的な利用想定の優先順位を計算してもよい。 The priority information update management unit 206 is a program that calculates the priority of various medical image processing based on the operation log collected by the operation log collection unit 204. The priority information update management unit 206 may calculate the priority for each individual based on the operation log acquired for each individual of the user 60, or statistically process the operation log of the plurality of users 60 for medical treatment. You may calculate the priority of the average usage assumption in the institution.
 画像処理自動要求部208は、DICOMサーバ50に保存される画像を取得し、取得された画像に適用する画像処理を選択し、優先度情報更新管理部206が定めた優先度情報に従い画像処理APIサーバ30に対して画像処理の要求を行うプログラムである。 The image processing automatic request unit 208 acquires an image stored in the DICOM server 50, selects an image process to be applied to the acquired image, and performs an image processing API according to the priority information determined by the priority information update management unit 206. This is a program that requests image processing from the server 30.
 画像処理APIサーバ30と各医療機関の医療機関内ネットワーク上に存在する画像処理自動要求部208との接続を確立することにより、相互の通信が可能になる。 By establishing a connection between the image processing API server 30 and the image processing automatic request unit 208 existing on the network in the medical institution of each medical institution, mutual communication becomes possible.
 画像処理APIサーバ30は、複数の医療機関のそれぞれの医療機関内ネットワーク上の画像処理自動要求部208から安全にアクセスできるネットワーク上に存在すればよく、物理マシン、仮想マシン等の形態は問わない。画像処理APIサーバ30は、クラウドサーバであってもよいし、オンプレミスサーバであってもよい。画像処理APIサーバ30は本開示における「画像処理サーバ」の一例である。 The image processing API server 30 may exist on a network that can be safely accessed from the image processing automatic request unit 208 on the respective medical institution networks of a plurality of medical institutions, and may be in any form such as a physical machine or a virtual machine. .. The image processing API server 30 may be a cloud server or an on-premises server. The image processing API server 30 is an example of the "image processing server" in the present disclosure.
 なお、図1では、ビューワ202、操作ログ収集部204、優先度情報更新管理部206および画像処理自動要求部208が1つの端末20上に構築されている例が示されているが、これらのプログラムは、医療機関内ネットワーク上に存在する2以上の端末に分散して構築されてもよい。例えば、ビューワ202は第1の端末上に構築され、操作ログ収集部204、優先度情報更新管理部206および画像処理自動要求部208は、第1の端末とは異なる第2の端末上に構築されてもよい。あるいはまた、ビューワ202、操作ログ収集部204、優先度情報更新管理部206および画像処理自動要求部208のそれぞれが別々の端末上に構築されてもよい。 Note that FIG. 1 shows an example in which the viewer 202, the operation log collection unit 204, the priority information update management unit 206, and the image processing automatic request unit 208 are constructed on one terminal 20. The program may be distributed and constructed in two or more terminals existing on the network in the medical institution. For example, the viewer 202 is built on the first terminal, and the operation log collection unit 204, the priority information update management unit 206, and the image processing automatic request unit 208 are built on a second terminal different from the first terminal. May be done. Alternatively, the viewer 202, the operation log collection unit 204, the priority information update management unit 206, and the image processing automatic request unit 208 may be constructed on separate terminals.
 図1中の手順[a]~[d]の流れは、モダリティ40にて検査画像が撮影されてから、画像処理APIサーバ30に対して処理要求が行われるまでの流れを示している。図1中の手順[0]~[4]の流れは、利用者60がビューワ202を使用した操作ログから各種画像処理の優先度を計算する流れを示している。手順[a]~[d]の流れと、手順[0]~[4]の流れは同時並行的に行われていてもよい。 The flow of the procedures [a] to [d] in FIG. 1 shows the flow from the inspection image being taken by the modality 40 to the processing request being made to the image processing API server 30. The flow of procedures [0] to [4] in FIG. 1 shows a flow in which the user 60 calculates the priority of various image processing from the operation log using the viewer 202. The flow of steps [a] to [d] and the flow of steps [0] to [4] may be performed in parallel.
 《医用画像処理方法の説明》
 図1中の手順[0]および手順[a]~[d]の流れを例に取り、利用者60が医用画像処理システム10をどのように利用するかの具体例を以下に説明する。
<< Explanation of medical image processing method >>
Taking the flow of the procedure [0] and the procedures [a] to [d] in FIG. 1 as an example, a specific example of how the user 60 uses the medical image processing system 10 will be described below.
 図2は、医用画像処理システム10の動作の流れを示すフローチャートである。まず、モダリティ40にて検査画像の撮影が行われる(ステップS11)。モダリティ40によって撮影された検査画像は、DICOMサーバ50に保存される(ステップS12、図1の手順[a])。 FIG. 2 is a flowchart showing the operation flow of the medical image processing system 10. First, the inspection image is taken by the modality 40 (step S11). The inspection image taken by the modality 40 is stored in the DICOM server 50 (step S12, procedure [a] in FIG. 1).
 続いて画像処理自動要求部208がDICOMサーバ50に新たに保存された画像を自動的に取得し(ステップS13、図1の手順[b])、画像処理自動要求部208が取得した画像に対してどのような処理を行えばよいか処理内容を判断する(ステップS14、図1の手順[c])。ここでの「自動的に」とは、利用者60からの都度の操作による指示の入力を必要とせずに、という意味を含んでおり、モダリティ40によって撮影された画像がDICOMサーバ50に保存される動作に連動してバックグラウンドで自動的に行われることを意味している。 Subsequently, the image processing automatic request unit 208 automatically acquires the image newly saved in the DICOM server 50 (step S13, procedure [b] in FIG. 1), and the image processing automatic request unit 208 obtains the image. The processing content is determined as to what kind of processing should be performed (step S14, procedure [c] in FIG. 1). Here, "automatically" means that the user does not need to input an instruction by each operation from the user 60, and the image taken by the modality 40 is saved in the DICOM server 50. It means that it is automatically performed in the background in conjunction with the operation.
 ここで画像処理自動要求部208が取得した画像に対して何の処理を行えばよいか判断する仕組みとして、例えば、画像処理自動要求部208は、取得した画像に対して臓器抽出処理を行って、どの臓器が写っているかという情報を抽出し、例えば肺が写っている場合には肺結節検出を実行する、というような判断でもよい。臓器ごとに実行可能な1つ以上の画像処理が紐付けられており、抽出した臓器に応じて実行可能な1つ以上の画像処理が判別される。1つの画像に対して実行可能な画像処理が複数あってもよい。 Here, as a mechanism for determining what processing should be performed on the image acquired by the image processing automatic request unit 208, for example, the image processing automatic request unit 208 performs organ extraction processing on the acquired image. , Information on which organ is shown may be extracted, and for example, if the lung is shown, lung nodule detection may be performed. One or more image processes that can be executed are associated with each organ, and one or more image processes that can be executed are determined according to the extracted organ. There may be a plurality of image processes that can be executed for one image.
 また、画像処理自動要求部208は、画像に付されたDICOMタグから得られる情報を処理適用可否判断基準に用いてもよい。DICOMタグから得られる情報として、例えば、CTスライス厚等の条件を用いてもよい。CTスライス厚が分厚いと、実施できない処理があり得る。したがって、CTスライス厚が所定の基準値以下である場合に処理を実施できる、という条件を定めておき、CTスライス厚の情報を基に、処理の適用の可否を判断してもよい。もちろん、臓器抽出の結果とCTスライス厚の条件との組み合わせによって処理の適用の可否を判断してもよい。 Further, the image processing automatic request unit 208 may use the information obtained from the DICOM tag attached to the image as the processing applicability determination criterion. As the information obtained from the DICOM tag, for example, conditions such as CT slice thickness may be used. If the CT slice thickness is thick, there may be some processing that cannot be performed. Therefore, it may be determined whether or not the treatment can be applied based on the information on the CT slice thickness, provided that the treatment can be performed when the CT slice thickness is equal to or less than a predetermined reference value. Of course, the applicability of the treatment may be determined by the combination of the result of organ extraction and the condition of CT slice thickness.
 また、DICOMタグだけからでも処理適用の可否判断を実行できるものもある。例えば、DICOMタグから造影剤を使った撮影であると分かれば、血管造影や血管の病変および/または異常を抽出する処理を実施する、というような判断が可能である。DICOMタグの情報は本開示における「タグ情報」の一例である。 In addition, there are some that can execute the judgment of applicability of processing only from the DICOM tag. For example, if it is known from the DICOM tag that the image is taken with a contrast medium, it is possible to determine that angiography or a process for extracting a lesion and / or an abnormality of a blood vessel is performed. The DICOM tag information is an example of "tag information" in the present disclosure.
 次いで、画像処理自動要求部208は、取得された画像に対して適用可と判断された処理の要求を画像処理APIサーバ30に対して送信する前に、画像処理APIサーバ30の負荷状況を把握するための動作を行う(ステップS15)。 Next, the image processing automatic request unit 208 grasps the load status of the image processing API server 30 before transmitting the processing request determined to be applicable to the acquired image to the image processing API server 30. (Step S15).
 ここで負荷状況の把握方法は、例えば、現在の画像処理APIサーバ30で待ち状態になっている処理個数を返すようなAPIエンドポイント(Endpoint)など、画像処理APIサーバ30側の負荷状況を応答するAPIエンドポイントを画像処理APIサーバ30側に備えておき、そのAPIエンドポイントを画像処理自動要求部208が使用し、その応答内容から画像処理APIサーバ30の負荷状況を取得してもよい。APIエンドポイントは本開示における「エンドポイント」の一例である。 Here, the method of grasping the load status responds to the load status on the image processing API server 30 side, such as an API endpoint (Endpoint) that returns the number of processes waiting in the current image processing API server 30. The API endpoint to be used may be provided on the image processing API server 30 side, the API endpoint may be used by the image processing automatic request unit 208, and the load status of the image processing API server 30 may be acquired from the response content. The API endpoint is an example of an "endpoint" in the present disclosure.
 また、負荷状況の把握方法の他の例として、画像処理自動要求部208が、今まで画像処理APIサーバ30に対して処理要求を送ってから、処理結果が得られるまでの応答時間を、処理要求毎に画像処理自動要求部208の内部に記録し、応答が返ってくるまでの時間の増加傾向を計算するなどして、負荷状況を把握するというような方法でもよい。 Further, as another example of the method of grasping the load status, the image processing automatic request unit 208 processes the response time from sending the processing request to the image processing API server 30 until the processing result is obtained. It may be possible to grasp the load status by recording each request in the image processing automatic request unit 208 and calculating the increasing tendency of the time until the response is returned.
 次いで、画像処理自動要求部208は、必要に応じて各処理の最新の優先度情報を優先度情報更新管理部206から取得する(ステップS16、図1の手順[4])。 Next, the image processing automatic request unit 208 acquires the latest priority information of each process from the priority information update management unit 206 as necessary (step S16, procedure [4] in FIG. 1).
 そして、画像処理自動要求部208はステップS15で把握した負荷状況を示す数値を閾値と照らし合わせ、閾値に応じた優先度の処理を画像処理APIサーバ30に対して要求する(ステップS17、図1の手順[d])。 Then, the image processing automatic request unit 208 compares the numerical value indicating the load status grasped in step S15 with the threshold value, and requests the image processing API server 30 to process the priority according to the threshold value (step S17, FIG. 1). Procedure [d]).
 例えば、優先度は、最も低いレベルを示す「1」から最も高いレベルを示す「100」までの100段階にレベル分けされており、優先度情報更新管理部206によって処理ごとに優先度が決定される。この場合、画像処理自動要求部208は、例えば、画像処理APIサーバ30の応答時間の増加率が、直近10リクエストで30%である場合は、優先度が30~100の処理の処理要求を送信するなどの態様があり得る。 For example, the priority is divided into 100 levels from "1" indicating the lowest level to "100" indicating the highest level, and the priority is determined for each process by the priority information update management unit 206. To. In this case, the image processing automatic request unit 208 transmits, for example, a processing request having a priority of 30 to 100 when the increase rate of the response time of the image processing API server 30 is 30% in the last 10 requests. And so on.
 なお、ここでは優先度の粒度の一例として優先度1~100の例を示したが、優先度の定義はこの例に限らない。複数の画像処理に関して柔軟に優先順位を設定するためには、優先度の粒度を細かくすることが望ましい。例えば、優先度は、最も低い優先度のレベルから最も高い優先度のレベルまでが50段階以上にレベル分けされていることが好ましく、100段階以上にレベル分けされていることがさらに好ましい。例えば、優先度のレベルを256段階に定義したり、1024段階に定義したりしてもよい。 Although the example of priority 1 to 100 is shown here as an example of the particle size of priority, the definition of priority is not limited to this example. In order to flexibly set priorities for multiple image processes, it is desirable to make the priority particles finer. For example, the priority is preferably divided into 50 or more levels from the lowest priority level to the highest priority level, and more preferably 100 or more levels. For example, the priority level may be defined in 256 levels or 1024 levels.
 画像処理自動要求部208から処理要求を受け取った画像処理APIサーバ30は、要求された処理を実行する(ステップS18)。 The image processing API server 30 that received the processing request from the image processing automatic request unit 208 executes the requested processing (step S18).
 その後、画像処理自動要求部208は、適当なタイミングで画像処理APIサーバ30から処理結果を取得する(ステップS20)。 After that, the image processing automatic request unit 208 acquires the processing result from the image processing API server 30 at an appropriate timing (step S20).
 ここで処理結果の取得の際に、処理結果が作成されたことを画像処理APIサーバ30から画像処理自動要求部208へ通知してもよいし、画像処理自動要求部208が定期的に画像処理APIサーバ30へ処理結果の有無を問い合わせて、処理結果ができている場合に取得するというような流れでもよい。 Here, when the processing result is acquired, the image processing API server 30 may notify the image processing automatic request unit 208 that the processing result has been created, or the image processing automatic request unit 208 periodically performs image processing. The flow may be such that the API server 30 is inquired about the existence of the processing result and the processing result is acquired when the processing result is obtained.
 画像処理APIサーバ30から処理結果を取得した画像処理自動要求部208は、その処理結果をビューワ202で参照できる形式にて保存する(ステップS21)。なお、処理結果の情報は、画像と関連付けされてDICOMサーバ50に保存されてもよい。 The image processing automatic request unit 208 that has acquired the processing result from the image processing API server 30 saves the processing result in a format that can be referred to by the viewer 202 (step S21). The processing result information may be associated with the image and stored in the DICOM server 50.
 その後、利用者60はビューワ202を通じて処理結果を参照することができる(ステップS22)。 After that, the user 60 can refer to the processing result through the viewer 202 (step S22).
 ここで画像処理自動要求部208からの処理要求に対して、画像処理APIサーバ30の計算資源が潤沢にある場合は、上記の手順にて利用者60が処理結果を参照する際に、ステップS13およびステップS14にて画像処理自動要求部208がDICOMサーバ50から取得した画像に対して適用可と判断された全ての処理結果がビューワ202にて参照可能となるという想定であるが、ステップS15にて画像処理APIサーバ30の負荷状況を勘案した結果、画像処理自動要求部208から送信する処理要求を絞った場合は、利用者60が処理結果を参照する時に一部結果が用意できていないことが想定される。
そのような場合の具体例について以下に述べる。
Here, when the calculation resource of the image processing API server 30 is abundant in response to the processing request from the image processing automatic request unit 208, when the user 60 refers to the processing result in the above procedure, step S13. It is assumed that all the processing results determined to be applicable to the image acquired from the DICOM server 50 by the image processing automatic request unit 208 in step S14 can be referred to in the viewer 202. As a result of considering the load status of the image processing API server 30, when the processing requests to be transmitted from the image processing automatic request unit 208 are narrowed down, some results cannot be prepared when the user 60 refers to the processing results. Is assumed.
Specific examples of such cases will be described below.
 〈具体例1〉
 例えば、画像から骨折検出を行う骨折CADと、骨番号のラベリングを行う骨ラベリングという二つの処理を考える。骨折CADは骨折を見つけるために診断ワークフローの最初に行われることが多いため、結果がビューワ202にて参照される回数も多く、骨折CADの処理結果が早い段階で利用者60側にて参照可能になることが望ましい。
<Specific example 1>
For example, consider two processes: fracture CAD for detecting a fracture from an image and bone labeling for labeling a bone number. Since fracture CAD is often performed at the beginning of the diagnostic workflow to find a fracture, the results are often referred to in the viewer 202, and the fracture CAD processing results can be referenced by the user 60 at an early stage. Is desirable.
 一方、骨ラベリングは、例えば、脊椎の第何番目かを自動認識する処理であり、骨ラベリングの結果として得られる骨番号のラベリングは、骨折CADにより骨折が検出された場合にはレポートにて骨折箇所の特定のために重要な役割を果たす一方、骨折が検出されなかった場合は骨番号をレポートに書く必要が無く、骨ラベリングは処理自体が行われていなくとも問題ない。また、骨折が検出されているが骨ラベリングの結果が無いという場合でも、利用者60側としては多少不便とはなるが、レポートの作成自体は自分で骨番号を特定することで可能である。このような理由から、本例に関しては画像処理の優先度として、「骨折CAD>骨ラベリング」というような判断を行うことができる。 On the other hand, bone labeling is, for example, a process of automatically recognizing the number of the spine, and the labeling of the bone number obtained as a result of bone labeling is a fracture in the report when the fracture is detected by the fracture CAD. While it plays an important role in identifying the location, if no fracture is detected, there is no need to write the bone number in the report, and bone labeling does not have to be done. Further, even if a fracture is detected but there is no result of bone labeling, it is a little inconvenient for the user 60 side, but the report itself can be created by specifying the bone number by oneself. For this reason, in this example, it is possible to make a determination such as "fracture CAD> bone labeling" as the priority of image processing.
 このような優先度の相対的な大小関係は、デフォルトの優先度の設定(出荷時設定)において定められていてもよいし、ビューワ202の操作ログの解析結果から決定されてもよい。例えば、デフォルトの優先度の設定があり、その後、それぞれの医療機関における利用者60の好み等を操作ログの解析から優先度に反映してもよい。 Such a relative magnitude relationship of priorities may be determined in the default priority setting (factory setting) or may be determined from the analysis result of the operation log of the viewer 202. For example, there is a default priority setting, and then the preference of the user 60 in each medical institution may be reflected in the priority from the analysis of the operation log.
 あるいはまた、何も優先度をつけずに最初はそれぞれの処理要求を画像処理APIサーバ30に送ることも考えられる。この場合、医師などの利用者60は、最初は処理結果が参照可能となるまでに時間がかかり不便を感じることも想定されるが、処理が終わるまで待ったものは優先度が高い処理、待たずに処理をキャンセルしたものは優先度が低い処理として、それぞれの処理に優先度を定めることができ、以後、その優先度が反映された処理が可能となる。 Alternatively, it is also conceivable to initially send each processing request to the image processing API server 30 without giving any priority. In this case, it is assumed that the user 60 such as a doctor may feel inconvenience because it takes time until the processing result can be referred to at first, but the processing waiting until the processing is completed is a high-priority processing and does not wait. If the process is canceled, the priority can be set for each process as a process with a low priority, and thereafter, the process that reflects the priority becomes possible.
 優先度について「骨折CAD>骨ラベリング」の関係がある場合、画像処理自動要求部208は、骨ラベリングの処理よりも骨折CADの処理要求を優先して行う。 When there is a relationship of "fracture CAD> bone labeling" regarding the priority, the image processing automatic request unit 208 prioritizes the processing request of the fracture CAD over the processing of the bone labeling.
 〈具体例2〉
 他の例として、肺結節検出と、肺区域ラベリングと、それら二つの処理結果を使用したレポート候補文生成処理との三つの処理がある。肺結節はなんらかの疾患を示している可能性があり、その肺結節の位置を検出する肺結節検出の結果は診断ワークフローの初期段階でよく参照される。
<Specific example 2>
As another example, there are three processes of lung nodule detection, lung area labeling, and report candidate sentence generation processing using these two processing results. Lung nodules may indicate some disease, and the results of lung nodule detection to detect the location of the lung nodules are often referred to early in the diagnostic workflow.
 一方、肺区域ラベリングは、肺の領域を区別しやすいように領域分けする機能であり、肺結節検出の結果よりは後に参照されることが多く、肺野画像に異常所見が見られない場合は、レポートに詳しい肺領域の名前を記載する必要がない場合もあり、肺区域ラベリングの結果が参照されないこともあり得る。 On the other hand, lung segment labeling is a function that divides the lung region so that it can be easily distinguished, and is often referred to after the result of lung nodule detection, and if there are no abnormal findings in the lung field image. , It may not be necessary to include the name of the lung region in detail in the report, and the results of lung segment labeling may not be referenced.
 このため、肺結節検出と肺区域ラベリングとのそれぞれの優先度の関係は、「肺結節検出>肺区域ラベリング」と言える。レポート候補文生成処理は、レポートに記載する所見文の候補を生成する処理である。レポート候補文生成機能は、肺結節検出の結果と肺区域ラベリングの結果を入力として所見文の候補を生成するが、所見文候補が無くても肺結節検出の結果や肺区域ラベリングの結果があれば、利用者60としては多少不便であるが、レポート作成は行える。このような観点から、三つの処理のそれぞれの優先度の関係は、「肺結節検出>肺区域ラベリング>レポート候補文生成」というような判断を行うことができる。この場合、画像処理自動要求部208は、肺結節検出の処理要求を優先して行うなどの処理が可能となる。レポート候補文生成処理は本開示における「レポート作成支援処理」の一例である。 Therefore, it can be said that the relationship between the priority of lung nodule detection and lung segment labeling is "lung nodule detection> lung segment labeling". The report candidate sentence generation process is a process of generating a candidate of the finding sentence to be described in the report. The report candidate sentence generation function generates candidates for findings by inputting the results of lung nodule detection and lung segment labeling, but even if there are no findings candidates, the results of lung nodule detection and lung segment labeling can be obtained. For example, although it is a little inconvenient for the user 60, it is possible to create a report. From this point of view, the relationship between the priorities of each of the three processes can be determined as "lung nodule detection> lung area labeling> report candidate sentence generation". In this case, the image processing automatic request unit 208 can perform processing such as giving priority to a processing request for detecting a lung nodule. The report candidate sentence generation process is an example of the "report creation support process" in the present disclosure.
 〈処理要求の送信判断の例〉
 上記の「具体例1」および「具体例2」において、各種医用画像処理の優先度の考えを具体的な例を示して説明した。画像処理APIサーバ30のリソースが逼迫している場合、例えば「具体例1」の例だと、骨折CAD→骨ラベリングの順で画像処理自動要求部208から画像処理APIサーバ30に対して要求が送信される。ここで、骨折CADの後に骨ラベリングの処理要求を送るかどうかの判断は、以下のような基準で、画像処理自動要求部208によって行われる。
<Example of transmission judgment of processing request>
In the above-mentioned "Specific Example 1" and "Specific Example 2", the idea of the priority of various medical image processings has been described by showing specific examples. When the resources of the image processing API server 30 are tight, for example, in the example of "Specific Example 1", a request is made to the image processing API server 30 from the image processing automatic request unit 208 in the order of fracture CAD → bone labeling. Will be sent. Here, the determination of whether or not to send the bone labeling processing request after the fracture CAD is performed by the image processing automatic request unit 208 based on the following criteria.
 [規則1]画像処理自動要求部208は、定期的にステップS15にて行っている画像処理APIサーバ30の負荷状況把握を行う。 [Rule 1] The image processing automatic request unit 208 periodically grasps the load status of the image processing API server 30 performed in step S15.
 [規則2]画像処理自動要求部208は、処理要求を送らなければいけないが、優先度が低いためにまだ送ることができていない処理要求(例えば、骨ラベリングの処理要求)を内部的に保持している。 [Rule 2] The image processing automatic request unit 208 must internally send a processing request, but internally holds a processing request (for example, a bone labeling processing request) that cannot be sent due to its low priority. is doing.
 [規則3]ステップS15にて把握した画像処理APIサーバ30の負荷状況の閾値が、保留中の処理要求(例:骨ラベリング)の優先度と照らし合わせたときに、保留中の処理要求を送信してもよい負荷状況となっていれば、保留中の画像要求を画像処理APIサーバ30に対して送信する。 [Rule 3] When the threshold value of the load status of the image processing API server 30 grasped in step S15 is compared with the priority of the pending processing request (eg, bone labeling), the pending processing request is transmitted. If the load condition is acceptable, the pending image request is transmitted to the image processing API server 30.
 ここで、一定時間経過しても画像処理APIサーバ30の負荷状況が改善せず、保留中の画像要求を送信がなかなかできないような場合に関して、一定時間経過後は保留中の画像処理要求の送信を取りやめるというようなタイムアウト時間を設けてもよい。なお、このタイムアウト時間の値は、設定ファイル等として固定値で与えられてもよいし、例えば画像処理自動要求部208が操作ログ収集部204にて収集された操作ログから読影ワークフローにかかる平均的な時間を割り出し、算出された時間に基づいてタイムアウト時間を動的に設定してもよい。例えば、その読影ワークフローが通常(平均的には)1回30分で終わるのであれば、その平均的な時間の2倍の60分経過しても保留中の画像処理要求が送れない場合は、その結果はもう必要とされないとして、60分をタイムアウト時間と設定するような動的設定を行ってもよい。 Here, in the case where the load status of the image processing API server 30 does not improve even after a certain period of time has elapsed and it is difficult to transmit the pending image request, the pending image processing request is transmitted after a certain period of time has elapsed. You may set a time-out time such as canceling. The value of this timeout time may be given as a fixed value as a setting file or the like. For example, the image processing automatic request unit 208 is an average of the operation logs collected by the operation log collection unit 204 for the interpretation workflow. The time-out time may be dynamically set based on the calculated time. For example, if the interpretation workflow normally (on average) ends in 30 minutes at a time, and if the pending image processing request cannot be sent after 60 minutes, which is twice the average time, then As the result is no longer needed, a dynamic setting may be made to set 60 minutes as the timeout period.
 〈優先度の計算方法の例〉
 これまで、各処理の優先度の考え方について述べてきた。ここでは図1中の手順[0]~[4]の流れを説明し、優先度計算に関する具体例を示す。図3は、優先度計算に関する動作の例を示すフローチャートである。
<Example of priority calculation method>
So far, we have described the concept of priority for each process. Here, the flow of procedures [0] to [4] in FIG. 1 will be described, and a specific example of priority calculation will be shown. FIG. 3 is a flowchart showing an example of the operation related to the priority calculation.
 図1の手順[0]にて、まず、利用者60はビューワ202を用いて各種画像処理結果を参照し、診断ワークフローを行う(図3のステップS51)。 In the procedure [0] of FIG. 1, first, the user 60 refers to various image processing results using the viewer 202 and performs a diagnostic workflow (step S51 of FIG. 3).
 次いで、手順[1]にて、操作ログ収集部204は利用者60によるビューワ202の操作の操作ログを収集する(ステップS52)。 Next, in the procedure [1], the operation log collection unit 204 collects the operation log of the operation of the viewer 202 by the user 60 (step S52).
 次いで、手順「2」にて、優先度情報更新管理部206は操作ログの中から処理要求の優先度計算に必要な情報を取得する(ステップS53)。優先度情報更新管理部206は、優先度計算に必要な情報として、例えば、処理結果の参照回数に関するログ、およびどの処理結果を参照した後にどの処理結果を参照したか、という参照順序の情報を取得する。 Next, in step "2", the priority information update management unit 206 acquires the information necessary for the priority calculation of the processing request from the operation log (step S53). As the information necessary for the priority calculation, the priority information update management unit 206 provides, for example, a log regarding the number of times the processing result is referenced and information on the reference order such as which processing result is referenced and then which processing result is referenced. get.
 必要な情報を取得した優先度情報更新管理部206は、手順[3]にて、それら情報を用いて各処理の優先度を計算する(ステップS54)。ここでの処理とは、例えば肺結節検出など、各医療機関内にある画像処理自動要求部208から画像処理APIサーバ30へ要求する処理のことである。優先度の計算においては、例えば、次のような優先度基準が適用される。 The priority information update management unit 206 that has acquired the necessary information calculates the priority of each process using the information in the procedure [3] (step S54). The process here is a process of requesting the image processing API server 30 from the image processing automatic request unit 208 in each medical institution, for example, lung nodule detection. In the calculation of priority, for example, the following priority criteria are applied.
 [優先度基準]数々の診断ワークフローにおいて、最初に参照され、かつ参照回数が多いものに高い優先度をつける。 [Priority Criteria] In a number of diagnostic workflows, the one that is referred to first and has a large number of references is given a high priority.
 これは、診断ワークフローにおいて最初に参照されることから、早めに処理結果を返す必要があるとの考え方に基づく基準である。具体例については既述の「具体例1」および「具体例2」で説明したとおりである。 This is a standard based on the idea that it is necessary to return the processing result as soon as possible because it is first referred to in the diagnostic workflow. Specific examples are as described in "Specific Example 1" and "Specific Example 2" described above.
 なお、以降の優先度の計算方法は、優先度情報更新管理部206が構築された情報処理装置への設定ファイルとして渡せるようになっていてもよいし、ソースコードとして直接実装されていてもよい。 The subsequent priority calculation method may be passed as a setting file to the information processing device in which the priority information update management unit 206 is constructed, or may be directly implemented as a source code. ..
 上記の「優先度基準」によって、結果が参照される回数の多い処理の優先度を高くしているが、参照回数以外の優先度基準として、次のような基準も考慮することも好ましい。すなわち、CADx系の処理の前段の処理にあたるCADe系の処理など、他の処理の前段として必要とされる処理の優先度も高くする必要があることが考えられる。CADx系の処理とは、性状分析を行う処理であり、例えば、ガンか、肺炎かなどを判別(鑑別)する処理がこれに該当する。一方、CADe系の処理とは、画像内から特定の領域や対象を検出する検出系の処理であり、例えば、異常な領域が画像上にあるかを検出し、異常領域を抽出する処理がこれに該当する。CADe系の処理によって異常領域が検出された場合に、CADx系の処理によって性状分析を行うという段階的な処理態様が考えられる。 The above "priority standard" raises the priority of processing in which the result is frequently referred to, but it is also preferable to consider the following criteria as priority criteria other than the number of references. That is, it is considered necessary to raise the priority of the processing required as the pre-stage of other processing, such as the CADe-based processing, which is the pre-stage processing of the CADx-based processing. The CADx-based process is a process for performing property analysis, and corresponds to, for example, a process for discriminating (differentiating) whether it is cancer or pneumonia. On the other hand, the CADe system processing is a detection system processing that detects a specific area or target from the image, for example, a processing that detects whether an abnormal area is on the image and extracts an abnormal area. Corresponds to. When an abnormal region is detected by the CADe system processing, a stepwise processing mode in which the property analysis is performed by the CADx system processing can be considered.
 このような状況に対応するために、例えば各種処理の優先度の値には、結果参照回数という値以外に、各処理に対してデフォルトの優先度値を属性として付与しておき、結果の参照回数はそのデフォルト値への加算値として与えてもよい。 In order to deal with such a situation, for example, in addition to the value of the number of result references, the default priority value is given as an attribute to the priority value of various processes, and the result reference. The number of times may be given as an addition value to the default value.
 例えば、CADe系の処理にはデフォルトの優先度値として優先度200を、CADx系の処理には優先度100をそれぞれ属性として与えておき、操作ログから特定される結果の参照回数は、そのデフォルト値への加算値として与えることにより、デフォルトの優先度値と実際の参照回数とが考慮された優先度の値が動的に設定されることになる。 For example, priority 200 is given as a default priority value for CADe-based processing, and priority 100 is given as an attribute for CADx-based processing, and the number of references to the result specified from the operation log is the default. By giving it as an addition value to the value, the priority value considering the default priority value and the actual number of references is dynamically set.
 また、例えば優先度200のあるCADe系の処理Aが、後段の優先度100の3種類のCADx系の処理B、処理Cおよび処理Dのそれぞれによって必要とされている場合、処理Aの優先度を200+100×3=500とするなど、他の処理からその処理結果を必要とされている処理ほど、その優先度を高くするというような優先度の計算ルールを設けてもよい。処理Aは例えば、肺内の異常領域抽出処理であり、処理Bは例えば、肺がんAI判断処理、処理Cは例えば、肺炎AI判断処理、処理Dは例えば、気管支炎AI判断処理などであってよい。肺内の異常領域抽出処理は本開示における「CADeの処理」の一例であり、肺がんAI判断処理、肺炎AI判断処理、および気管支炎AI判断処理のそれぞれは本開示における「CADxの処理」の一例である。 Further, for example, when the CADe-based process A having a priority of 200 is required by each of the three types of CADx-based processes B, C, and D of the subsequent priority 100, the priority of the process A. May be set to 200 + 100 × 3 = 500, and a priority calculation rule may be provided such that the higher the priority is, the higher the priority is for the process that requires the process result from other processes. The process A may be, for example, an abnormal region extraction process in the lung, the process B may be, for example, a lung cancer AI determination process, the process C may be, for example, a pneumonia AI determination process, and the process D may be, for example, a bronchitis AI determination process. .. The abnormal region extraction process in the lung is an example of "CADe treatment" in the present disclosure, and each of the lung cancer AI judgment process, the pneumonia AI judgment process, and the bronchitis AI judgment process is an example of "CADx treatment" in the present disclosure. Is.
 ステップS54(図1の手順[3])にて計算された優先度情報は、優先度情報更新管理部206に保存される(ステップS55)。画像処理自動要求部208は、図2で説明したステップS16およびステップS17のようなタイミングで画像処理の処理要求を送る前に、各処理の最新の優先度情報を取得する。 The priority information calculated in step S54 (procedure [3] in FIG. 1) is stored in the priority information update management unit 206 (step S55). The image processing automatic request unit 208 acquires the latest priority information of each process before sending the image processing process request at the timings such as step S16 and step S17 described with reference to FIG.
 《システム構成例》
 次に、医用画像処理システム10の具体的な構成の例について説明する。図4は、医用画像処理システム10のシステム構成例を概略的に示す図である。まず、医療機関内ネットワーク100の例を説明する。図4では、図示を簡単にするために、複数の医療機関のそれぞれに同じシステム構成の医療機関内ネットワーク100が構築されている例を示すが、医療機関ごとに異なるシステム構成の医療機関内ネットワークが構築されてもよい。
<< System configuration example >>
Next, an example of a specific configuration of the medical image processing system 10 will be described. FIG. 4 is a diagram schematically showing a system configuration example of the medical image processing system 10. First, an example of the network 100 in a medical institution will be described. FIG. 4 shows an example in which a medical institution network 100 having the same system configuration is constructed in each of a plurality of medical institutions for the sake of simplicity, but the medical institution network having a different system configuration for each medical institution is shown. May be constructed.
 医療機関内ネットワーク100は、モダリティ40と、DICOMサーバ50と、画像処理管理端末20Aと、ビューワ端末22と、電子カルテシステム24と、構内通信回線26とを含むコンピュータネットワークである。 The medical institution network 100 is a computer network including a modality 40, a DICOM server 50, an image processing management terminal 20A, a viewer terminal 22, an electronic medical record system 24, and a premises communication line 26.
 なお、医療機関内ネットワーク100には、複数種類のモダリティ40が含まれてもよい。医療機関内ネットワーク100に接続されるモダリティ40の種類は、医療機関ごとに様々な組み合わせがありうる。 The network 100 in the medical institution may include a plurality of types of modality 40. There may be various combinations of modality 40 types connected to the medical institution network 100 for each medical institution.
 DICOMサーバ50は、構内通信回線26を介して他の装置と通信を行い、画像データを含む各種データを送受信する。DICOMサーバ50は、モダリティ40によって生成された画像データその他の含む各種データを構内通信回線26経由で受信し、大容量外部記憶装置等の記録媒体に保存して管理する。なお、画像データの格納形式および構内通信回線26経由での各装置間の通信は、DICOMのプロトコルに基づいている。 The DICOM server 50 communicates with other devices via the premises communication line 26, and transmits / receives various data including image data. The DICOM server 50 receives image data and other various data generated by the modality 40 via the premises communication line 26, and stores and manages the data in a recording medium such as a large-capacity external storage device. The storage format of the image data and the communication between the devices via the premises communication line 26 are based on the DICOM protocol.
 画像処理管理端末20Aは、図1で説明した端末20に相当する情報処理装置である。画像処理管理端末20Aの形態は特に限定されず、パーソナルコンピュータであってもよいし、ワークステーションであってもよく、また、タブレット端末などであってもよい。画像処理管理端末20Aは、画像処理APIサーバ30と通信するための通信機能を有し、広域通信回線120を介して画像処理APIサーバ30と接続される。画像処理管理端末20Aは、構内通信回線26を介してDICOMサーバ50等からデータを取得することができる。また、画像処理管理端末20Aは、画像処理APIサーバ30から取得した処理結果をDICOMサーバ50およびビューワ端末22に送ることができる。画像処理管理端末20Aは、ビューワ端末22と兼用されてもよい。 The image processing management terminal 20A is an information processing device corresponding to the terminal 20 described with reference to FIG. The form of the image processing management terminal 20A is not particularly limited, and may be a personal computer, a workstation, a tablet terminal, or the like. The image processing management terminal 20A has a communication function for communicating with the image processing API server 30, and is connected to the image processing API server 30 via the wide area communication line 120. The image processing management terminal 20A can acquire data from the DICOM server 50 or the like via the premises communication line 26. Further, the image processing management terminal 20A can send the processing result acquired from the image processing API server 30 to the DICOM server 50 and the viewer terminal 22. The image processing management terminal 20A may also be used as the viewer terminal 22.
 DICOMサーバ50のデータベースに保存された各種データ、並びに画像処理管理端末20Aが取得した処理結果を含む様々な情報は、ビューワ端末22に表示させることができる。 Various data stored in the database of the DICOM server 50 and various information including the processing result acquired by the image processing management terminal 20A can be displayed on the viewer terminal 22.
 ビューワ端末22は、PACSビューワ、あるいはDICOMビューワと呼ばれる画像閲覧用の端末である。医療機関内ネットワーク100には複数のビューワ端末22が接続され得る。ビューワ端末22の形態は特に限定されず、パーソナルコンピュータであってもよいし、ワークステーションであってもよく、また、タブレット端末などであってもよい。 The viewer terminal 22 is a terminal for viewing images called a PACS viewer or a DICOM viewer. A plurality of viewer terminals 22 may be connected to the medical institution network 100. The form of the viewer terminal 22 is not particularly limited, and may be a personal computer, a workstation, a tablet terminal, or the like.
 図4に示すように、複数の医療機関のそれぞれに、同様のシステム構成を持つ医療機関内ネットワークが構築されている。 As shown in FIG. 4, a network within a medical institution having a similar system configuration is constructed in each of a plurality of medical institutions.
 画像処理APIサーバ30は、広域通信回線120を介して、各医療機関の画像処理管理端末20Aと通信を行う。広域通信回線120は本開示における「ネットワーク」の一例である。画像処理APIサーバ30は、複数の画像処理を行うことができ、画像処理管理端末20Aからの処理要求に応じて各種の画像処理サービスを提供する。 The image processing API server 30 communicates with the image processing management terminal 20A of each medical institution via the wide area communication line 120. The wide area communication line 120 is an example of the "network" in the present disclosure. The image processing API server 30 can perform a plurality of image processing, and provides various image processing services in response to a processing request from the image processing management terminal 20A.
 画像処理APIサーバ30によって提供される画像処理には、例えば、骨折の位置を検出する骨折検出処理、骨番号のラベリングを行う骨ラベリング処理、肺結節の位置を検出する肺結節検出処理、肺結節の性状を鑑別する肺結節性状鑑別処理、肺区域のラベリングを肺区域ラベリング処理のうち少なくとも1つの処理が含まれてよい。画像処理APIサーバ30によって提供される画像処理には、他にも、臓器セグメンテーション処理、血管領域抽出処理、脳CAD処理、乳腺CAD処理、肝臓CAD処理、大腸CAD処理およびレポート作成支援処理などがありうる。 Image processing The image processing provided by the API server 30 includes, for example, a fracture detection process for detecting the position of a fracture, a bone labeling process for labeling bone numbers, a lung nodule detection process for detecting the position of a lung nodule, and a lung nodule. The lung nodule property differentiation process for differentiating the properties of the lung nodule, and the labeling of the lung area may include at least one process of the lung area labeling process. Image processing The image processing provided by the API server 30 also includes organ segmentation processing, blood vessel region extraction processing, brain CAD processing, breast CAD processing, liver CAD processing, large intestine CAD processing, and report creation support processing. sell.
 《画像処理APIサーバ30の構成例》
 図5は、画像処理APIサーバ30の構成例を示すブロック図である。画像処理APIサーバ30は、1台または複数台のコンピュータを用いて構成されるコンピュータシステムによって実現することができる。コンピュータにプログラムをインストールすることにより画像処理APIサーバ30の各種の機能が実現される。
<< Configuration example of image processing API server 30 >>
FIG. 5 is a block diagram showing a configuration example of the image processing API server 30. The image processing API server 30 can be realized by a computer system configured by using one or a plurality of computers. By installing a program on the computer, various functions of the image processing API server 30 are realized.
 画像処理APIサーバ30は、プロセッサ302、非一時的な有体物であるコンピュータ可読媒体304、通信インターフェース306、入出力インターフェース308、バス310、入力装置314および表示装置316を備える。プロセッサ302は本開示における「第1のプロセッサ」の一例である。コンピュータ可読媒体304は本開示における「第1の記憶装置」の一例である。 The image processing API server 30 includes a processor 302, a non-temporary tangible computer-readable medium 304, a communication interface 306, an input / output interface 308, a bus 310, an input device 314, and a display device 316. The processor 302 is an example of the "first processor" in the present disclosure. The computer-readable medium 304 is an example of the "first storage device" in the present disclosure.
 プロセッサ302はCPU(Central Processing Unit)を含む。プロセッサ302はGPU(Graphics Processing Unit)を含んでもよい。プロセッサ302は、バス310を介してコンピュータ可読媒体304、通信インターフェース306および入出力インターフェース308と接続される。入力装置314および表示装置316は入出力インターフェース308を介してバス310に接続される。 The processor 302 includes a CPU (Central Processing Unit). The processor 302 may include a GPU (Graphics Processing Unit). The processor 302 is connected to the computer-readable medium 304, the communication interface 306, and the input / output interface 308 via the bus 310. The input device 314 and the display device 316 are connected to the bus 310 via the input / output interface 308.
 コンピュータ可読媒体304は、主記憶装置であるメモリおよび補助記憶装置であるストレージを含む。コンピュータ可読媒体304は、例えば、半導体メモリ、ハードディスク(HDD:Hard Disk Drive)装置、もしくはソリッドステートドライブ(SSD:Solid State Drive)装置またはこれらの複数の組み合わせであってよい。 The computer-readable medium 304 includes a memory as a main storage device and a storage as an auxiliary storage device. The computer-readable medium 304 may be, for example, a semiconductor memory, a hard disk (HDD: Hard Disk Drive) device, a solid state drive (SSD: Solid State Drive) device, or a combination thereof.
 画像処理APIサーバ30は通信インターフェース306を介して広域通信回線120(図4参照)に接続される。 The image processing API server 30 is connected to the wide area communication line 120 (see FIG. 4) via the communication interface 306.
 コンピュータ可読媒体304には、複数の画像処理を含む各種の処理を行うための複数のプログラムおよびデータ等が格納される。コンピュータ可読媒体304には、例えば、臓器セグメンテーションプログラム320、血管領域抽出プログラム322、骨折CADプログラム324、骨ラベリングプログラム326、肺結節検出プログラム330、肺結節性状分析プログラム332、肺炎CADプログラム334、肺区域ラベリングプログラム336、乳腺CADプログラム340、肝臓CADプログラム342、脳CADプログラム344、大腸CADプログラム346、およびレポート作成支援プログラム348などのうち1つ以上のプログラムが格納されてよい。レポート作成支援プログラム348は、所見文候補生成プログラム349を含む。これらの各種の処理プログラムは、深層学習などの機械学習を適用して目的のタスクの出力が得られるように学習された学習済みモデルを含むAI処理モジュールであってよい。 The computer-readable medium 304 stores a plurality of programs, data, and the like for performing various processes including a plurality of image processes. The computer-readable medium 304 includes, for example, an organ segmentation program 320, a vascular region extraction program 322, a fracture CAD program 324, a bone labeling program 326, a lung nodule detection program 330, a lung nodule property analysis program 332, a pneumonia CAD program 334, and a lung area. One or more of the labeling program 336, the breast CAD program 340, the liver CAD program 342, the brain CAD program 344, the colon CAD program 346, the report creation support program 348, and the like may be stored. The report creation support program 348 includes a finding sentence candidate generation program 349. These various processing programs may be AI processing modules including trained models trained to apply machine learning such as deep learning to obtain the output of the desired task.
 CAD用のAIモデルは、例えば、畳み込み層を有する各種の畳み込みニューラルネットワーク(CNN:Convolutional Neural Network)を用いて構成することができる。AIモデルに対する入力データは、例えば、2次元画像、3次元画像または動画像など医用画像を含み、AIモデルからの出力は例えば、画像内における疾病領域(病変部位)などの位置を示す情報、もしくは病名などのクラス分類を示す情報、またはこれらの組み合わせであってよい。 The AI model for CAD can be configured by using, for example, various convolutional neural networks (CNN: Convolutional Neural Network) having a convolutional layer. The input data for the AI model includes, for example, a medical image such as a two-dimensional image, a three-dimensional image or a moving image, and the output from the AI model is, for example, information indicating the position of a diseased area (lesion site) in the image, or It may be information indicating a classification such as a disease name, or a combination thereof.
 時系列データや文書データなどを扱うAIモデルは、例えば、各種の再帰型ニューラルネットワーク(RNN:Recurrent Neural Network)を用いて構成することができる。時系列データには、例えば心電図の波形データなどが含まれる。文書データには、例えば、医師によって作成される所見文などが含まれる。 An AI model that handles time-series data, document data, etc. can be configured using, for example, various recurrent neural networks (RNNs). The time series data includes, for example, ECG waveform data. Document data includes, for example, findings created by a doctor.
 図5に例示した処理プログラムのそれぞれは本開示における「処理モジュール」の一例である。骨折CADプログラム324および肺結節検出プログラム330のそれぞれは本開示における「CADeモジュール」の一例である。肺結節性状分析プログラム332および肺炎CADプログラム334のそれぞれは本開示における「CADxモジュール」の一例である。画像処理APIサーバ30に実装される処理プログラムの種類および組み合わせは様々な形態があり得る。コンピュータ可読媒体304に記憶されている各種処理プログラムを含むサーバプログラムは本開示における「第1のプログラム」の一例である。 Each of the processing programs illustrated in FIG. 5 is an example of the "processing module" in the present disclosure. Each of the fracture CAD program 324 and the lung nodule detection program 330 is an example of the "CADe module" in the present disclosure. Each of the lung nodule property analysis program 332 and the pneumonia CAD program 334 is an example of the "CADx module" in the present disclosure. The types and combinations of processing programs implemented in the image processing API server 30 can have various forms. A server program including various processing programs stored in the computer-readable medium 304 is an example of the "first program" in the present disclosure.
 プロセッサ302が、これらの処理プログラムの命令を実行することにより、画像処理APIサーバ30のコンピュータは、処理プログラムに対応した処理部として機能する。例えば、プロセッサ302が臓器セグメンテーションプログラム320の命令を実行することにより、画像処理APIサーバ30のコンピュータは、臓器セグメンテーション処理を行う臓器セグメンテーション処理部として機能する。他のプログラムについても同様である。 When the processor 302 executes the instructions of these processing programs, the computer of the image processing API server 30 functions as a processing unit corresponding to the processing program. For example, when the processor 302 executes an instruction of the organ segmentation program 320, the computer of the image processing API server 30 functions as an organ segmentation processing unit that performs organ segmentation processing. The same applies to other programs.
 プロセッサ302は、コンピュータ可読媒体304に記憶されているプログラムの命令を実行することにより、各医療機関の画像処理管理端末20Aから処理対象の画像と処理要求とを受け取り、処理要求に対応した画像処理を実施して処理結果を要求元に返す動作を行う。この画像処理APIサーバ30が実行する動作は本開示における「第1の動作」の一例である。 The processor 302 receives the image to be processed and the processing request from the image processing management terminal 20A of each medical institution by executing the instruction of the program stored in the computer-readable medium 304, and performs image processing corresponding to the processing request. Is executed and the processing result is returned to the request source. The operation executed by the image processing API server 30 is an example of the "first operation" in the present disclosure.
 また、コンピュータ可読媒体304には、表示制御プログラム350が格納される。表示制御プログラム350は、表示装置316への表示出力に必要な表示用信号を生成し、表示装置316の表示制御を行う。 Further, the display control program 350 is stored in the computer-readable medium 304. The display control program 350 generates a display signal necessary for display output to the display device 316, and controls the display of the display device 316.
 表示装置316は、例えば、液晶ディスプレイ、有機EL(organic electro-luminescence:OEL)ディスプレイ、もしくは、プロジェクタ、またはこれらの適宜の組み合わせによって構成される。入力装置314は、例えば、キーボード、マウス、タッチパネル、もしくはその他のポインティングデバイス、もしくは、音声入力装置、またはこれらの適宜の組み合わせによって構成される。入力装置314は、オペレータによる種々の入力を受け付ける。なお、タッチパネルを用いることによって表示装置316と入力装置314とを一体に構成してもよい。 The display device 316 is composed of, for example, a liquid crystal display, an organic EL (organic electro-luminescence: OEL) display, a projector, or an appropriate combination thereof. The input device 314 is composed of, for example, a keyboard, a mouse, a touch panel, or other pointing device, a voice input device, or an appropriate combination thereof. The input device 314 accepts various inputs by the operator. The display device 316 and the input device 314 may be integrally configured by using the touch panel.
 《画像処理管理端末20Aの構成例》
 図6は、医療機関内ネットワーク100上の画像処理管理端末20Aの構成例を示すブロック図である。画像処理管理端末20Aは、1台または複数台のコンピュータを用いて構成されるコンピュータシステムによって実現することができる。
<< Configuration example of image processing management terminal 20A >>
FIG. 6 is a block diagram showing a configuration example of the image processing management terminal 20A on the network 100 in the medical institution. The image processing management terminal 20A can be realized by a computer system configured by using one or a plurality of computers.
 画像処理管理端末20Aは、プロセッサ212、非一時的な有体物であるコンピュータ可読媒体214、通信インターフェース216、入出力インターフェース218、バス220、入力装置224および表示装置226を備える。画像処理管理端末20Aのハードウェア構成は、図5で説明した画像処理APIサーバ30のハードウェア構成と同様であってよい。すなわち、図6に示すプロセッサ212、コンピュータ可読媒体214、通信インターフェース216、入出力インターフェース218、バス220、入力装置224および表示装置226のそれぞれのハードウェア構成は、図5に示す対応する要素と同様であってよい。 The image processing management terminal 20A includes a processor 212, a non-temporary tangible computer readable medium 214, a communication interface 216, an input / output interface 218, a bus 220, an input device 224, and a display device 226. The hardware configuration of the image processing management terminal 20A may be the same as the hardware configuration of the image processing API server 30 described with reference to FIG. That is, the hardware configurations of the processor 212, the computer readable medium 214, the communication interface 216, the input / output interface 218, the bus 220, the input device 224, and the display device 226 shown in FIG. 6 are the same as the corresponding elements shown in FIG. It may be.
 プロセッサ212は本開示における「第2のプロセッサ」および「プロセッサ」の一例である。コンピュータ可読媒体214は本開示における「第2の記憶装置」および「記憶装置」の一例である。 The processor 212 is an example of the "second processor" and the "processor" in the present disclosure. The computer-readable medium 214 is an example of the "second storage device" and the "storage device" in the present disclosure.
 画像処理管理端末20Aは、通信インターフェース216を介してビューワ端末22、DICOMサーバ50および画像処理APIサーバ30と接続される。 The image processing management terminal 20A is connected to the viewer terminal 22, the DICOM server 50, and the image processing API server 30 via the communication interface 216.
 コンピュータ可読媒体214には、医用画像処理要求最適化プログラム200と表示制御プログラム260とを含む各種プログラムおよびデータが記憶される。医用画像処理要求最適化プログラム200は、操作ログ収集部204、優先度情報更新管理部206および画像処理自動要求部208を含む。また、コンピュータ可読媒体214は、操作ログ収集部204によって収集された操作ログのデータを保存および管理する操作ログデータベース205と、画像処理自動要求部208が画像処理APIサーバ30から取得した画像処理結果を保存する処理結果保存部264とを含む。表示制御プログラム260は、表示装置226への表示出力に必要な表示用信号を生成し、表示装置226の表示制御を行う。 The computer-readable medium 214 stores various programs and data including the medical image processing request optimization program 200 and the display control program 260. The medical image processing request optimization program 200 includes an operation log collection unit 204, a priority information update management unit 206, and an image processing automatic request unit 208. Further, the computer-readable medium 214 has an operation log database 205 that stores and manages operation log data collected by the operation log collection unit 204, and an image processing result acquired by the image processing automatic request unit 208 from the image processing API server 30. Includes a processing result storage unit 264 for storing the data. The display control program 260 generates a display signal necessary for display output to the display device 226, and controls the display of the display device 226.
 プロセッサ212は、コンピュータ可読媒体214に記憶されている医用画像処理要求最適化プログラム200の命令を実行することにより、ビューワ端末22の操作ログを収集することと、収集した操作ログを基に、各画像処理の優先度を計算することと、計算によって得られた優先度の情報を記録し、各画像処理の優先度情報の更新および管理を行うことと、モダリティ40によって撮影された新たな画像を取得することと、取得された新たな画像に対して何の画像処理を実行できるかを判別することと、画像処理APIサーバ30の負荷状況を把握することと、判別された実行可能な画像処理のそれぞれの優先度と画像処理APIサーバ30の負荷状況とに基づき、画像処理APIサーバ30に対して優先度の基準に従い、処理要求を送信することとを含む動作を行う。この画像処理管理端末20Aが実行する動作は本開示における「第2の動作」の一例である。 The processor 212 collects the operation log of the viewer terminal 22 by executing the instruction of the medical image processing request optimization program 200 stored in the computer readable medium 214, and based on the collected operation log, each Calculate the priority of image processing, record the priority information obtained by the calculation, update and manage the priority information of each image processing, and create a new image taken by modality 40. To acquire, to determine what image processing can be executed for the acquired new image, to grasp the load status of the image processing API server 30, and to determine the determined executable image processing. Based on each priority of the above and the load status of the image processing API server 30, an operation including sending a processing request to the image processing API server 30 according to the priority standard is performed. The operation executed by the image processing management terminal 20A is an example of the "second operation" in the present disclosure.
 医用画像処理要求最適化プログラム200は本開示における「第2のプログラム」および「プログラム」の一例である。なお、ここでは、1つの画像処理管理端末20Aに、操作ログ収集部204、優先度情報更新管理部206および画像処理自動要求部208を構築する例を示しているが、医用画像処理要求最適化プログラム200の処理機能は、2以上の複数台のコンピュータで処理の機能を分担して実現してもよい。 The medical image processing request optimization program 200 is an example of the "second program" and the "program" in the present disclosure. Although an example of constructing an operation log collection unit 204, a priority information update management unit 206, and an image processing automatic request unit 208 in one image processing management terminal 20A is shown here, medical image processing request optimization is shown. The processing function of the program 200 may be realized by sharing the processing function among two or more computers.
 《ビューワ端末22の構成例》
 図7は、ビューワ端末22の構成例を示すブロック図である。ビューワ端末22のハードウェア構成は、図6で説明した画像処理管理端末20Aのハードウェア構成と同様であってよい。ビューワ端末22は、プロセッサ232、コンピュータ可読媒体234、通信インターフェース236、入出力インターフェース238、バス240、入力装置244および表示装置246を備える。それぞれのハードウェア構成は、図6に示した構成の対応する要素と同様であってよい。
<< Configuration example of viewer terminal 22 >>
FIG. 7 is a block diagram showing a configuration example of the viewer terminal 22. The hardware configuration of the viewer terminal 22 may be the same as the hardware configuration of the image processing management terminal 20A described with reference to FIG. The viewer terminal 22 includes a processor 232, a computer-readable medium 234, a communication interface 236, an input / output interface 238, a bus 240, an input device 244, and a display device 246. Each hardware configuration may be similar to the corresponding element of the configuration shown in FIG.
 コンピュータ可読媒体234は、医用画像閲覧用プログラムであるビューワ202と、ビューワ202の操作ログを保存する操作ログ保存部203と、表示制御プログラム262とを含む。 The computer-readable medium 234 includes a viewer 202, which is a medical image viewing program, an operation log storage unit 203 for storing the operation log of the viewer 202, and a display control program 262.
 ビューワ202は、通信インターフェース236を介して接続されたDICOMサーバ50から読み出した画像および画像処理の処理結果を含む各種の情報を表示装置246に表示させる。また、ビューワ202は利用者60が入力装置244を操作した履歴(操作ログ)を操作ログ保存部203に保存する。操作ログ保存部203に保存された操作ログのデータは、画像処理管理端末20Aの操作ログ収集部204に送られる。表示制御プログラム262は、表示装置246への表示出力に必要な表示用信号を生成し、表示装置246の表示制御を行う。 The viewer 202 causes the display device 246 to display various information including the image read from the DICOM server 50 connected via the communication interface 236 and the processing result of the image processing. Further, the viewer 202 saves the history (operation log) in which the user 60 operates the input device 244 in the operation log storage unit 203. The operation log data saved in the operation log storage unit 203 is sent to the operation log collection unit 204 of the image processing management terminal 20A. The display control program 262 generates a display signal necessary for display output to the display device 246, and controls the display of the display device 246.
 《コンピュータのハードウェア構成の例》
 図8は、コンピュータのハードウェア構成の例を示すブロック図である。コンピュータ800は、パーソナルコンピュータであってもよいし、ワークステーションであってもよく、また、サーバコンピュータであってもよい。コンピュータ800は、既に説明した端末20、画像処理APIサーバ30、DICOMサーバ50、電子カルテシステム24、画像処理管理端末20A、ビューワ端末22のいずれかの一部または全部、あるいはこれらの複数の機能を備えた装置として用いることができる。
<< Example of computer hardware configuration >>
FIG. 8 is a block diagram showing an example of a computer hardware configuration. The computer 800 may be a personal computer, a workstation, or a server computer. The computer 800 has a part or all of the terminal 20, the image processing API server 30, the DICOM server 50, the electronic medical record system 24, the image processing management terminal 20A, and the viewer terminal 22 described above, or a plurality of functions thereof. It can be used as a equipped device.
 コンピュータ800は、CPU802、RAM(Random Access Memory)804、ROM(Read Only Memory)806、GPU808、ストレージ810、通信部812、入力装置814、表示装置816およびバス818を備える。なお、GPU808は、必要に応じて設ければよい。 The computer 800 includes a CPU 802, a RAM (RandomAccessMemory) 804, a ROM (ReadOnlyMemory) 806, a GPU 808, a storage 810, a communication unit 812, an input device 814, a display device 816, and a bus 818. The GPU 808 may be provided as needed.
 CPU802は、ROM806またはストレージ810等に記憶された各種のプログラムを読み出し、各種の処理を実行する。RAM804は、CPU802の作業領域として使用される。また、RAM804は、読み出されたプログラムおよび各種のデータを一時的に記憶する記憶部として用いられる。 The CPU 802 reads various programs stored in the ROM 806, the storage 810, or the like, and executes various processes. The RAM 804 is used as a work area of the CPU 802. Further, the RAM 804 is used as a storage unit for temporarily storing the read program and various data.
 ストレージ810は、例えば、ハードディスク装置、光ディスク、光磁気ディスク、もしくは半導体メモリ、またはこれらの適宜の組み合わせを用いて構成される記憶装置を含んで構成される。ストレージ810には、各種プログラムやデータ等が記憶される。ストレージ810に記憶されているプログラムがRAM804にロードされ、これをCPU802が実行することにより、コンピュータ800は、プログラムで規定される各種の処理を行う手段として機能する。 The storage 810 includes, for example, a hard disk device, an optical disk, a magneto-optical disk, or a semiconductor memory, or a storage device configured by using an appropriate combination thereof. Various programs, data, and the like are stored in the storage 810. The program stored in the storage 810 is loaded into the RAM 804, and the CPU 802 executes the program, so that the computer 800 functions as a means for performing various processes specified by the program.
 通信部812は、有線または無線により外部装置との通信処理を行い、外部装置との間で情報のやり取りを行うインターフェースである。通信部812は、画像等の入力を受け付ける情報取得部の役割を担うことができる。 The communication unit 812 is an interface that performs communication processing with an external device by wire or wirelessly and exchanges information with the external device. The communication unit 812 can play the role of an information acquisition unit that accepts input such as an image.
 入力装置814は、コンピュータ800に対する各種の操作入力を受け付ける入力インターフェースである。入力装置814は、例えば、キーボード、マウス、タッチパネル、もしくはその他のポインティングデバイス、もしくは、音声入力装置、またはこれらの適宜の組み合わせであってよい。 The input device 814 is an input interface that accepts various operation inputs to the computer 800. The input device 814 may be, for example, a keyboard, mouse, touch panel, or other pointing device, or voice input device, or any combination thereof.
 表示装置816は、各種の情報が表示される出力インターフェースである。表示装置816は、例えば、液晶ディスプレイ、有機EL(organic electro-luminescence:OEL)ディスプレイ、もしくは、プロジェクタ、またはこれらの適宜の組み合わせであってよい。 The display device 816 is an output interface for displaying various information. The display device 816 may be, for example, a liquid crystal display, an organic electro-luminescence (OEL) display, a projector, or an appropriate combination thereof.
 《コンピュータを動作させるプログラムについて》
 上記の実施形態で説明した端末20および画像処理管理端末20Aにおける操作ログ収集機能、優先度情報更新管理機能、および画像処理自動要求機能、ならびに画像処理APIサーバ30における各種の画像処理機能などの各種の処理機能のうち少なくとも1つの処理機能の一部または全部をコンピュータに実現させるプログラムを、光ディスク、磁気ディスク、もしくは、半導体メモリその他の有体物たる非一時的な情報記憶媒体であるコンピュータ可読媒体に記録し、この情報記憶媒体を通じてプログラムを提供することが可能である。
<< About the program that operates the computer >>
Various functions such as an operation log collection function, a priority information update management function, an image processing automatic request function, and various image processing functions in the image processing API server 30 in the terminal 20 and the image processing management terminal 20A described in the above embodiment. A program that enables a computer to realize a part or all of at least one of the processing functions of the above is recorded on a computer-readable medium such as an optical disk, a magnetic disk, or a semiconductor memory or other tangible non-temporary information storage medium. However, it is possible to provide the program through this information storage medium.
 またこのような有体物たる非一時的なコンピュータ可読媒体にプログラムを記憶させて提供する態様に代えて、インターネットなどの電気通信回線を利用してプログラム信号をダウンロードサービスとして提供することも可能である。 It is also possible to provide the program signal as a download service using a telecommunication line such as the Internet, instead of storing and providing the program in such a tangible non-temporary computer-readable medium.
 《各処理部のハードウェア構成について》
 端末20および画像処理管理端末20Aにおける操作ログ収集部204、優先度情報更新管理部206、画像処理自動要求部208などの各種の処理を実行する処理部(processing unit)のハードウェア的な構造は、例えば、次に示すような各種のプロセッサ(processor)である。
<< About the hardware configuration of each processing unit >>
The hardware structure of the processing unit that executes various processes such as the operation log collection unit 204, the priority information update management unit 206, and the image processing automatic request unit 208 in the terminal 20 and the image processing management terminal 20A is For example, various processors as shown below.
 各種のプロセッサには、プログラムを実行して各種の処理部として機能する汎用的なプロセッサであるCPU、画像処理に特化したプロセッサであるGPU、FPGA(Field Programmable Gate Array)などの製造後に回路構成を変更可能なプロセッサであるプログラマブルロジックデバイス(Programmable Logic Device:PLD)、ASIC(Application Specific Integrated Circuit)などの特定の処理を実行させるために専用に設計された回路構成を有するプロセッサである専用電気回路などが含まれる。 For various processors, CPU, which is a general-purpose processor that executes programs and functions as various processing units, GPU, which is a processor specialized in image processing, FPGA (Field Programmable Gate Array), etc., are configured after manufacturing. A dedicated electric circuit that is a processor with a circuit configuration specially designed to execute a specific process such as a programmable logic device (PLD) or ASIC (Application Specific Integrated Circuit), which is a processor that can change the CPU. Etc. are included.
 1つの処理部は、これら各種のプロセッサのうちの1つで構成されていてもよいし、同種または異種の2つ以上のプロセッサで構成されてもよい。例えば、1つの処理部は、複数のFPGA、あるいは、CPUとFPGAの組み合わせ、またはCPUとGPUの組み合わせによって構成されてもよい。また、複数の処理部を1つのプロセッサで構成してもよい。複数の処理部を1つのプロセッサで構成する例としては、第一に、クライアントやサーバなどのコンピュータに代表されるように、1つ以上のCPUとソフトウェアの組み合わせで1つのプロセッサを構成し、このプロセッサが複数の処理部として機能する形態がある。第二に、システムオンチップ(System On Chip:SoC)などに代表されるように、複数の処理部を含むシステム全体の機能を1つのIC(Integrated Circuit)チップで実現するプロセッサを使用する形態がある。このように、各種の処理部は、ハードウェア的な構造として、上記各種のプロセッサを1つ以上用いて構成される。 One processing unit may be composed of one of these various processors, or may be composed of two or more processors of the same type or different types. For example, one processing unit may be configured by a plurality of FPGAs, a combination of a CPU and an FPGA, or a combination of a CPU and a GPU. Further, a plurality of processing units may be configured by one processor. As an example of configuring a plurality of processing units with one processor, first, one processor is configured by a combination of one or more CPUs and software, as represented by a computer such as a client or a server. There is a form in which the processor functions as a plurality of processing units. Secondly, as typified by System On Chip (SoC), there is a form that uses a processor that realizes the functions of the entire system including multiple processing units with one IC (Integrated Circuit) chip. be. As described above, the various processing units are configured by using one or more of the above-mentioned various processors as a hardware-like structure.
 さらに、これらの各種のプロセッサのハードウェア的な構造は、より具体的には、半導体素子などの回路素子を組み合わせた電気回路(circuitry)である。 Furthermore, the hardware-like structure of these various processors is, more specifically, an electric circuit (circuitry) in which circuit elements such as semiconductor elements are combined.
 《本実施形態による利点》
 本発明の実施形態に係る医用画像処理システム10によれば、次のような利点がある。
<< Advantages of this embodiment >>
According to the medical image processing system 10 according to the embodiment of the present invention, there are the following advantages.
 [1]モダリティ40によって新たな画像が撮影されると、その新たな画像が自動的に画像処理自動要求部208に取得され、画像処理APIサーバ30の負荷状況に合わせて必要な画像処理の処理要求が自動的に行われる。画像処理APIサーバ30のリソースが逼迫している状況の場合には、優先度の低い処理の処理要求が抑制され、利用者60にとって必要性が高い(優先度の高い)処理に絞って処理要求が送られるため、ユーザビリティを確保しつつ、システム全体の安定性を確保できる。 [1] When a new image is taken by the modality 40, the new image is automatically acquired by the image processing automatic request unit 208, and necessary image processing processing is performed according to the load status of the image processing API server 30. The request is made automatically. When the resources of the image processing API server 30 are tight, the processing request for low-priority processing is suppressed, and the processing request is limited to the processing that is highly necessary (high priority) for the user 60. Is sent, so it is possible to ensure the stability of the entire system while ensuring usability.
 [2]利用者がビューワ202を用いて処理結果等を参照した際の操作ログを基に、各画像処理の優先度が計算されるため、利用者にとって必要性の高い処理結果あるいは優先順位の高い処理結果を適切に決定することができる。また、優先度情報更新管理部206にて、適宜のタイミングで優先度が計算され、優先度情報が更新されるため、利用者60等による優先度の設定作業など複雑な作業が不要である。 [2] Since the priority of each image processing is calculated based on the operation log when the user refers to the processing result or the like using the viewer 202, the processing result or priority that is highly necessary for the user is calculated. High processing results can be appropriately determined. Further, since the priority information update management unit 206 calculates the priority at an appropriate timing and updates the priority information, complicated work such as priority setting work by the user 60 or the like is unnecessary.
 [3]本実施形態に係る医用画像処理システム10によれば、モダリティ40による画像の撮影後、短時間で利用者60にとって必要性の高い画像処理結果を閲覧できる状態となるため診断業務の効率化を図ることができる。 [3] According to the medical image processing system 10 according to the present embodiment, after the image is taken by the modality 40, the image processing result highly necessary for the user 60 can be viewed in a short time, so that the efficiency of the diagnostic work is high. Can be achieved.
 《その他》
 以上説明した本発明の実施形態は、本発明の趣旨を逸脱しない範囲で、適宜構成を変更、追加、または削除することが可能である。本発明は以上説明した実施形態に限定されるものではなく、本発明の技術的思想内で当該分野の通常の知識を有する者により、多くの変形が可能である。
"others"
The embodiments of the present invention described above can be appropriately modified, added, or deleted without departing from the spirit of the present invention. The present invention is not limited to the embodiments described above, and many modifications can be made by a person having ordinary knowledge in the art within the technical idea of the present invention.
10 医用画像処理システム
20 端末
20A 画像処理管理端末
22 ビューワ端末
24 電子カルテシステム
26 構内通信回線
30 画像処理APIサーバ
40 モダリティ
50 DICOMサーバ
60 利用者
100 医療機関内ネットワーク
120 広域通信回線
200 医用画像処理要求最適化プログラム
202 ビューワ
203 操作ログ保存部
204 操作ログ収集部
205 操作ログデータベース
206 優先度情報更新管理部
208 画像処理自動要求部
212 プロセッサ
214 コンピュータ可読媒体
216 通信インターフェース
218 入出力インターフェース
220 バス
224 入力装置
226 表示装置
232 プロセッサ
234 コンピュータ可読媒体
236 通信インターフェース
238 入出力インターフェース
240 バス
244 入力装置
246 表示装置
260 表示制御プログラム
262 表示制御プログラム
264 処理結果保存部
302 プロセッサ
304 コンピュータ可読媒体
306 通信インターフェース
308 入出力インターフェース
310 バス
314 入力装置
316 表示装置
320 臓器セグメンテーションプログラム
322 血管領域抽出プログラム
324 骨折CADプログラム
326 骨ラベリングプログラム
330 肺結節検出プログラム
332 肺結節性状分析プログラム
334 肺炎CADプログラム
336 肺区域ラベリングプログラム
340 乳腺CADプログラム
342 肝臓CADプログラム
344 脳CADプログラム
346 大腸CADプログラム
348 レポート作成支援プログラム
349 所見文候補生成プログラム
350 表示制御プログラム
800 コンピュータ
802 CPU
804 RAM
806 ROM
808 GPU
810 ストレージ
812 通信部
814 入力装置
816 表示装置
818 バス
S11~S22 医用画像処理システムの動作を示すステップ
S51~S55 優先度の計算処理のステップ
10 Medical image processing system 20 Terminal 20A Image processing management terminal 22 Viewer terminal 24 Electronic chart system 26 On-site communication line 30 Image processing API server 40 Modality 50 DICOM server 60 User 100 Medical institution network 120 Wide area communication line 200 Medical image processing request Optimization program 202 Viewer 203 Operation log storage unit 204 Operation log collection unit 205 Operation log database 206 Priority information update management unit 208 Image processing automatic request unit 212 Processor 214 Computer readable medium 216 Communication interface 218 Communication interface 218 Input / output interface 220 Bus 224 Input device 226 Display device 232 Processor 234 Computer-readable medium 236 Communication interface 238 Input / output interface 240 Bus 244 Input device 246 Display device 260 Display control program 262 Display control program 264 Processing result storage unit 302 Processor 304 Computer-readable medium 306 Communication interface 308 Input / output interface 310 Bus 314 Input device 316 Display device 320 Organ segmentation program 322 Vascular region extraction program 324 Fracture CAD program 326 Bone labeling program 330 Pulmonary nodule detection program 332 Pulmonary nodule property analysis program 334 Pneumonia CAD program 336 Pulmonary area labeling program 340 Breast CAD program 342 Liver CAD program 344 Brain CAD program 346 Colon CAD program 348 Report creation support program 349 Finding candidate generation program 350 Display control program 800 Computer 802 CPU
804 RAM
806 ROM
808 GPU
810 Storage 812 Communication unit 814 Input device 816 Display device 818 Bus S11 to S22 Steps S51 to S55 showing the operation of the medical image processing system Step of calculation processing of priority

Claims (22)

  1.  医用画像の画像処理を行う画像処理サーバと、前記画像処理サーバにネットワークを介して接続される情報処理装置とを含む医用画像処理システムであって、
     前記画像処理サーバは、1つ以上の第1のプロセッサを備え、
     前記第1のプロセッサは、複数の画像処理を行うための複数の処理モジュールを実行し、
     前記情報処理装置から処理対象の画像と処理要求とを受け取り、前記処理要求に対応した画像処理を実施して処理結果を要求元に返し、
     前記情報処理装置は、1つ以上の第2のプロセッサを備え、
     前記第2のプロセッサは、
     前記情報処理装置が接続される医療機関内ネットワーク上で利用者が前記画像処理の処理結果を閲覧する際に用いられる画像ビューワの操作ログを収集し、
     前記収集した前記操作ログを基に、前記複数の画像処理のそれぞれの優先度を計算し、
     前記計算によって得られた前記優先度の情報を記録し、前記複数の画像処理のそれぞれの優先度情報の更新および管理を行い、
     前記医療機関内ネットワークに接続された1つ以上のモダリティによって撮影された新たな画像を取得し、
     前記取得された前記新たな画像に対して、前記複数の画像処理のうち何の画像処理を実行できるかを判別し、
     前記画像処理サーバの負荷状況を把握し、
     前記判別された実行可能な1つ以上の画像処理のそれぞれの優先度と、前記把握された前記画像処理サーバの負荷状況とに基づき、前記画像処理サーバに対して前記優先度の基準に従い、前記実行可能な1つ以上の画像処理の処理要求を送信する、
     医用画像処理システム。
    A medical image processing system including an image processing server that performs image processing of medical images and an information processing device connected to the image processing server via a network.
    The image processing server comprises one or more first processors.
    The first processor executes a plurality of processing modules for performing a plurality of image processing, and the first processor executes a plurality of processing modules.
    The image to be processed and the processing request are received from the information processing apparatus, image processing corresponding to the processing request is performed, and the processing result is returned to the request source.
    The information processing device comprises one or more second processors.
    The second processor is
    The operation log of the image viewer used when the user browses the processing result of the image processing on the network in the medical institution to which the information processing device is connected is collected.
    Based on the collected operation log, the priority of each of the plurality of image processes is calculated.
    The priority information obtained by the calculation is recorded, and the priority information of each of the plurality of image processes is updated and managed.
    Acquire new images taken by one or more modality connected to the medical institution network and
    It is determined which of the plurality of image processes can be executed for the acquired new image.
    Understand the load status of the image processing server and
    Based on the respective priorities of the determined and one or more feasible image processing and the grasped load status of the image processing server, the image processing server is described according to the priority criteria. Send a processing request for one or more feasible image processing,
    Medical image processing system.
  2.  前記画像処理サーバは、複数の医療機関のそれぞれの前記情報処理装置からアクセスできる前記ネットワーク上に設置される、
     請求項1に記載の医用画像処理システム。
    The image processing server is installed on the network accessible from the information processing apparatus of each of the plurality of medical institutions.
    The medical image processing system according to claim 1.
  3.  前記ネットワークを介して前記画像処理サーバに接続される複数の前記情報処理装置を含み、
     前記複数の前記情報処理装置のそれぞれは、互いに異なる医療機関の医療機関内ネットワークに接続される端末を含む、
     請求項1または2に記載の医用画像処理システム。
    A plurality of the information processing devices connected to the image processing server via the network are included.
    Each of the plurality of information processing devices includes a terminal connected to a medical institutional network of different medical institutions.
    The medical image processing system according to claim 1 or 2.
  4.  前記医療機関内ネットワーク上には、前記1つ以上の前記モダリティによって撮影された画像を保存する画像保存サーバが設置される、
     請求項1から3のいずれか一項に記載の医用画像処理システム。
    An image storage server for storing images taken by the one or more modality is installed on the medical institution network.
    The medical image processing system according to any one of claims 1 to 3.
  5.  前記情報処理装置は、
     前記操作ログから前記画像処理の処理結果の参照回数および参照順序の情報を取得し、前記参照回数および前記参照順序の情報を用いて各画像処理の優先度を計算する、
     請求項1から4のいずれか一項に記載の医用画像処理システム。
    The information processing device is
    Information on the number of references and the reference order of the processing result of the image processing is acquired from the operation log, and the priority of each image processing is calculated using the information on the number of references and the reference order.
    The medical image processing system according to any one of claims 1 to 4.
  6.  前記情報処理装置は、
     前記画像ビューワを兼ねる、
     請求項1から5のいずれか一項に記載の医用画像処理システム。
    The information processing device is
    Also serves as the image viewer
    The medical image processing system according to any one of claims 1 to 5.
  7.  前記医療機関内ネットワークには、複数の前記画像ビューワが接続され、
     前記情報処理装置は、
     複数の前記画像ビューワのそれぞれの前記操作ログを収集し、
     収集した複数の前記操作ログに記録された情報を統計処理することにより、前記優先度を計算する、
     請求項1から6のいずれか一項に記載の医用画像処理システム。
    A plurality of the image viewers are connected to the medical institution network.
    The information processing device is
    The operation log of each of the plurality of image viewers is collected, and the operation log is collected.
    The priority is calculated by statistically processing the information recorded in the plurality of collected operation logs.
    The medical image processing system according to any one of claims 1 to 6.
  8.  前記情報処理装置は、
     前記取得された前記新たな画像に写っている臓器を抽出する臓器抽出処理を行い、
     前記抽出された前記臓器の情報に基づき、前記複数の画像処理の中から前記臓器に関連する前記画像処理を前記実行可能な画像処理として判別する、
     請求項1から7のいずれか一項に記載の医用画像処理システム。
    The information processing device is
    An organ extraction process for extracting the organs shown in the acquired new image is performed.
    Based on the extracted information on the organ, the image processing related to the organ is discriminated as the executable image processing from the plurality of image processes.
    The medical image processing system according to any one of claims 1 to 7.
  9.  前記情報処理装置は、
     前記取得された前記新たな画像に付されているタグ情報に基づき、前記複数の画像処理の中から前記実行可能な画像処理を判別する、
     請求項1から8のいずれか一項に記載の医用画像処理システム。
    The information processing device is
    Based on the tag information attached to the acquired new image, the executable image processing is determined from the plurality of image processes.
    The medical image processing system according to any one of claims 1 to 8.
  10.  前記画像処理サーバは、
     前記情報処理装置からの負荷状況の問い合わせを受けて、現在の負荷状況を応答するエンドポイントを備え、
     前記情報処理装置は、前記エンドポイントを使用し、前記エンドポイントから前記画像処理サーバの負荷状況を示す情報を取得する、
     請求項1から9のいずれか一項に記載の医用画像処理システム。
    The image processing server is
    It is equipped with an endpoint that receives an inquiry about the load status from the information processing device and responds to the current load status.
    The information processing apparatus uses the endpoint and acquires information indicating a load status of the image processing server from the endpoint.
    The medical image processing system according to any one of claims 1 to 9.
  11.  前記情報処理装置は、
     前記画像処理サーバに対して処理要求を送信してから処理結果が得られるまでの応答時間を前記処理要求ごとに記録し、前記応答時間の増加率を計算することにより、前記画像処理サーバの負荷状況を把握する、
     請求項1から9のいずれか一項に記載の医用画像処理システム。
    The information processing device is
    The load of the image processing server is obtained by recording the response time from the transmission of the processing request to the image processing server until the processing result is obtained for each processing request and calculating the increase rate of the response time. Understand the situation,
    The medical image processing system according to any one of claims 1 to 9.
  12.  前記情報処理装置は、
     前記把握された前記画像処理サーバの負荷状況を示す数値を閾値と照らし合わせ、
     閾値に応じた前記優先度の処理の処理要求を前記画像処理サーバに送信する、
     請求項1から11のいずれか一項に記載の医用画像処理システム。
    The information processing device is
    By comparing the grasped numerical value indicating the load status of the image processing server with the threshold value,
    A processing request for processing the priority according to the threshold value is transmitted to the image processing server.
    The medical image processing system according to any one of claims 1 to 11.
  13.  前記優先度は、最も低い優先度のレベルから最も高い優先度のレベルまでが50段階以上にレベル分けされている、
     請求項1から12のいずれか一項に記載の医用画像処理システム。
    The priority is divided into 50 or more levels from the lowest priority level to the highest priority level.
    The medical image processing system according to any one of claims 1 to 12.
  14.  前記複数の画像処理は、
     コンピュータ検出支援(Computer Aided Detection:CADe)の処理およびコンピュータ診断支援(Computer Aided Diagnosis:CADx)の処理のうち少なくとも1つの処理を含む、
     請求項1から13のいずれか一項に記載の医用画像処理システム。
    The plurality of image processing is
    Includes at least one of Computer Aided Detection (CADe) processing and Computer Aided Diagnosis (CADx) processing.
    The medical image processing system according to any one of claims 1 to 13.
  15.  前記複数の処理モジュールは、
     CADeの処理を行うCADeモジュールと、
     CADxの処理を行うCADxモジュールと、を含む、
     請求項14に記載の医用画像処理システム。
    The plurality of processing modules are
    A CADe module that processes CADe, and
    Includes a CADx module that processes CADx,
    The medical image processing system according to claim 14.
  16.  デフォルトの設定において、
     前記CADeの処理の優先度は、前記CADxの処理の優先度よりも高い優先度に設定される、
     請求項15に記載の医用画像処理システム。
    In the default settings
    The priority of the CADe process is set to a higher priority than the priority of the CADx process.
    The medical image processing system according to claim 15.
  17.  前記複数の処理モジュールは、
     所見文の候補を生成する処理を含むレポート作成支援処理を行う処理モジュールを含む、
     請求項14から16のいずれか一項に記載の医用画像処理システム。
    The plurality of processing modules are
    Includes a processing module that performs report creation support processing including processing to generate candidate findings,
    The medical image processing system according to any one of claims 14 to 16.
  18.  デフォルトの設定において、
     前記レポート作成支援処理の優先度は、前記CADeの処理の優先度および前記CADxの処理の優先度よりも低い優先度に設定される、
     請求項17に記載の医用画像処理システム。
    In the default settings
    The priority of the report creation support process is set to a priority lower than the priority of the CADe process and the priority of the CADx process.
    The medical image processing system according to claim 17.
  19.  前記複数の画像処理は、
     骨折の位置を検出する骨折検出処理と、
     骨番号のラベリングを行う骨ラベリング処理と、
     肺結節の位置を検出する肺結節検出処理と、
     前記肺結節の性状を鑑別する性状鑑別処理と、
     肺区域のラベリングを肺区域ラベリング処理と、
    のうち少なくとも1つの処理を含む、
     請求項1から18のいずれか一項に記載の医用画像処理システム。
    The plurality of image processing is
    Fracture detection processing to detect the position of the fracture and
    Bone labeling process for labeling bone numbers and
    Lung nodule detection process to detect the position of lung nodule,
    The property discrimination process for differentiating the properties of the lung nodule,
    Lung area labeling with lung area labeling treatment,
    Including at least one of the processes,
    The medical image processing system according to any one of claims 1 to 18.
  20.  複数の画像処理を行うことができる画像処理サーバにネットワークを介して接続された情報処理装置から処理対象の画像と処理要求とを前記画像処理サーバに送り、前記画像処理サーバにて前記処理要求に対応した画像処理を実施して処理結果を要求元に返す医用画像処理方法であって、
     前記情報処理装置が接続される医療機関内ネットワーク上において利用者が前記画像処理の処理結果を閲覧する際に用いられる画像ビューワの操作ログを収集することと、
     前記収集した前記操作ログを基に、前記複数の画像処理のそれぞれの優先度を計算することと、
     前記計算によって得られた前記優先度の情報を記録し、前記複数の画像処理のそれぞれの優先度情報の更新および管理を行うことと、
     前記医療機関内ネットワークに接続された1つ以上のモダリティによって撮影された新たな画像を取得することと、
     前記取得された前記新たな画像に対して、前記複数の画像処理のうち何の画像処理を実行できるかを判別することと、
     前記画像処理サーバの負荷状況を把握することと、
     前記判別された実行可能な1つ以上の画像処理のそれぞれの優先度と、前記把握された前記画像処理サーバの負荷状況とに基づき、前記画像処理サーバに対して前記優先度の基準に従い、前記実行可能な1つ以上の画像処理の処理要求を行うことと、を含む、
     医用画像処理方法。
    An information processing device connected to an image processing server capable of performing a plurality of image processing via a network sends an image to be processed and a processing request to the image processing server, and the image processing server responds to the processing request. It is a medical image processing method that performs corresponding image processing and returns the processing result to the requester.
    Collecting the operation log of the image viewer used when the user browses the processing result of the image processing on the network in the medical institution to which the information processing device is connected.
    Based on the collected operation log, the priority of each of the plurality of image processes is calculated, and
    Recording the priority information obtained by the calculation, updating and managing the priority information of each of the plurality of image processes, and
    Acquiring new images taken by one or more modality connected to the medical institution network,
    Determining which of the plurality of image processes can be executed for the acquired new image, and
    Understanding the load status of the image processing server and
    Based on the respective priorities of the determined and one or more feasible image processing and the grasped load status of the image processing server, the image processing server is described according to the priority criteria. Making processing requests for one or more feasible image processing, including.
    Medical image processing method.
  21.  複数の画像処理を行うことができる画像処理サーバにネットワークを介して接続される情報処理装置であって、
     1つ以上のプロセッサを備え、
     前記プロセッサは、
     前記情報処理装置が接続される医療機関内ネットワーク上で利用者が前記画像処理の処理結果を閲覧する際に用いられる画像ビューワの操作ログを収集し、
     前記収集した前記操作ログを基に、前記複数の画像処理のそれぞれの優先度を計算し、
     前記計算によって得られた前記優先度の情報を記録し、前記複数の画像処理のそれぞれの優先度情報の更新および管理を行い、
     前記医療機関内ネットワークに接続された1つ以上のモダリティによって撮影された新たな画像を取得し、
     前記取得された前記新たな画像に対して、前記複数の画像処理のうち何の画像処理を実行できるかを判別し、
     前記画像処理サーバの負荷状況を把握し、
     前記判別された実行可能な1つ以上の画像処理のそれぞれの優先度と、前記把握された前記画像処理サーバの負荷状況とに基づき、前記画像処理サーバに対して前記優先度の基準に従い、前記実行可能な1つ以上の画像処理の処理要求を送信する、
     情報処理装置。
    An information processing device connected to an image processing server capable of performing multiple image processing via a network.
    Equipped with one or more processors
    The processor
    The operation log of the image viewer used when the user browses the processing result of the image processing on the network in the medical institution to which the information processing device is connected is collected.
    Based on the collected operation log, the priority of each of the plurality of image processes is calculated.
    The priority information obtained by the calculation is recorded, and the priority information of each of the plurality of image processes is updated and managed.
    Acquire new images taken by one or more modality connected to the medical institution network and
    It is determined which of the plurality of image processes can be executed for the acquired new image.
    Understand the load status of the image processing server and
    Based on the respective priorities of the determined and one or more feasible image processing and the grasped load status of the image processing server, the image processing server is described according to the priority criteria. Send a processing request for one or more feasible image processing,
    Information processing equipment.
  22.  複数の画像処理を行うことができる画像処理サーバにネットワークを介して接続される情報処理装置としてコンピュータを機能させるためのプログラムであって、
     コンピュータに、
     前記情報処理装置が接続される医療機関内ネットワーク上で利用者が前記画像処理の処理結果を閲覧する際に用いられる画像ビューワの操作ログを収集する機能と、
     前記収集した前記操作ログを基に、前記複数の画像処理のそれぞれの優先度を計算する機能と、
     前記計算によって得られた前記優先度の情報を記録し、前記複数の画像処理のそれぞれの優先度情報の更新および管理を行う機能と、
     前記医療機関内ネットワークに接続された1つ以上のモダリティによって撮影された新たな画像を取得する機能と、
     前記取得された前記新たな画像に対して、前記複数の画像処理のうち何の画像処理を実行できるかを判別する機能と、
     前記画像処理サーバの負荷状況を把握する機能と、
     前記判別された実行可能な1つ以上の画像処理のそれぞれの優先度と、前記把握された前記画像処理サーバの負荷状況とに基づき、前記画像処理サーバに対して前記優先度の基準に従い、前記実行可能な1つ以上の画像処理の処理要求を送信する機能と、
     を実現させるためのプログラム。
    A program for operating a computer as an information processing device connected to an image processing server capable of performing multiple image processing via a network.
    On the computer
    A function to collect the operation log of the image viewer used when the user browses the processing result of the image processing on the network in the medical institution to which the information processing device is connected.
    A function to calculate the priority of each of the plurality of image processes based on the collected operation log, and
    A function of recording the priority information obtained by the calculation and updating and managing the priority information of each of the plurality of image processes.
    A function to acquire new images taken by one or more modality connected to the medical institution network, and
    A function for determining which image processing can be executed among the plurality of image processes for the acquired new image, and a function for determining which image processing can be executed.
    The function to grasp the load status of the image processing server and
    Based on the respective priorities of the determined and one or more feasible image processing and the grasped load status of the image processing server, the image processing server is described according to the priority criteria. The ability to send one or more feasible image processing requests, and
    A program to realize.
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